OBJECTIVE: To determine risk factors of overt/non-overt disseminated intravascular coagulation (DIC) in abdominal aortic aneurysm (AAA) patients undergoing endovascular aneurysm repair (EVAR). METHODS: In a retrospective study, 117 patients undergoing selective EVAR for AAA were investigated for overt/non-overt DIC from June 1st 2013 to December 31 2014. The following parameters were reviewed: D-dimer, Platelet count, fibrinogen and prothrombin time (PT) at before operation and 1, 2, and 7 days after operation. Non-overt DIC was defined as International Society on Thrombosis and Hemostasis (ISTH) score between 2 and 5, and overt DIC score ≥5. Factors associated with overt/non-overt DIC were identified by stepwise Logistic regression. RESULTS: Among 117 patients, who received EVAR for AAA, 3 patients (2. 5%) were diagnosed as overt DIC and 31 patients (26. 5%) were diagnosed as non-overt DIC. Univariate analysis showed significant risk factors for overt/non-overt DIC were aging, operating duration, blood loss, renal dysfunction and endoleak (P <0. 05). Stepwise Logistic regression showed that independent risk factors for overt/non-overt DIC were endoleak (B = 2. 118, SE = 0. 917, Wald =5. 335,P =0. 021), renal dysfunction (B = 2. 135, SE =0. 797, Wald = 7. 183, P = 0. 007) and operating duration (B = 0. 021, SE = 0. 006, Wald = 11. 126, P = 0. 001). CONCLUSION: Independent risk factors for non-overt DIC in patients who received EVAR for AAA are endoleak, renal dysfunction and operating duration.
OBJECTIVE: To determine risk factors of overt/non-overt disseminated intravascular coagulation (DIC) in abdominal aortic aneurysm (AAA) patients undergoing endovascular aneurysm repair (EVAR). METHODS: In a retrospective study, 117 patients undergoing selective EVAR for AAA were investigated for overt/non-overt DIC from June 1st 2013 to December 31 2014. The following parameters were reviewed: D-dimer, Platelet count, fibrinogen and prothrombin time (PT) at before operation and 1, 2, and 7 days after operation. Non-overt DIC was defined as International Society on Thrombosis and Hemostasis (ISTH) score between 2 and 5, and overt DIC score ≥5. Factors associated with overt/non-overt DIC were identified by stepwise Logistic regression. RESULTS: Among 117 patients, who received EVAR for AAA, 3 patients (2. 5%) were diagnosed as overt DIC and 31 patients (26. 5%) were diagnosed as non-overt DIC. Univariate analysis showed significant risk factors for overt/non-overt DIC were aging, operating duration, blood loss, renal dysfunction and endoleak (P <0. 05). Stepwise Logistic regression showed that independent risk factors for overt/non-overt DIC were endoleak (B = 2. 118, SE = 0. 917, Wald =5. 335,P =0. 021), renal dysfunction (B = 2. 135, SE =0. 797, Wald = 7. 183, P = 0. 007) and operating duration (B = 0. 021, SE = 0. 006, Wald = 11. 126, P = 0. 001). CONCLUSION: Independent risk factors for non-overt DIC in patients who received EVAR for AAA are endoleak, renal dysfunction and operating duration.
Authors: Danii Ls Suijk; Mark M Smits; Marcel Ha Muskiet; Lennart Tonneijck; Mark Hh Kramer; Jaap A Joles; Daniël H van Raalte Journal: Nephrology (Carlton) Date: 2019-09-12 Impact factor: 2.506