An analysis of risk factors of perioperative bleeding in surgical repair of abdominal aortic aneurysm

Background. In surgical repair of abdominal aortic aneurysm (AAA), excessiv e bleeding which causes postoperative complications is sometimes observed. To determine the risk factors of perioperative excessive blood loss, this r etrospective study was performed. Methods. Design. A retrospective study. Setting. An academic medical center . Participants. One hundred and for ty patients underwent elective surgical repair of an abdominal aortic aneurysm (AAA) at our institution from 1995 through 1997. Measurements. The present study includes critical review of 1 40 consecutive charts of patients undergoing elective surgical repair of AA A. Preoperative laboratory data, intraoperative data and amount of blood lo ss to identify risk factors of perioperative blood loss. Factors which were found to be significantly associated with the amount of perioperative bloo d loss were preoperative plasma fibrin degradation product (FDP) level (r=0 .445), amount of immediate re-infusion of shed blood (r=0.438), and duratio n of operation (r=0.411). Results. Preoperative fibrinogen level correlated with perioperative blood loss Little (r=-0.187). Preoperative platelet count or the other coagulatio n profile did not affect the amount of perioperative blood loss. The patien ts whose preoperative FDP were more than 40 mu g.ml(-1) significantly incre ased the risk of excessive blood loss compared with less than 40 mu g.ml(-1 ). Conclusions. The significant preoperative risk factor of perioperative bloo d loss was only FDP level in present study. Especially, the patients whose preoperative FDP were more than 40 mu g.ml(-1) increased the risk of excess ive blood loss.