Preoperative clinical application of human fibrinogen in patients with
acute Stanford type A aortic dissection: A Single-center Retrospective
Study.
Abstract
Objective: To evaluate the perioperative clinical efficacy of
preoperative human fibrinogen treatment in patients with acute Stanford
type A aortic dissection (ATAAD). Methods: Data of 159 patients
with ATAAD who underwent emergency surgical treatment in our hospital
from January 2019 to December 2020 were retrospectively analyzed.
Patients were divided into two groups according to whether human
fibrinogen was administered before surgery. The preoperative clinical
data, surgical data, postoperative data, complications related to the
coagulation function, and mortality of the two groups were compared and
analyzed. Results: The in-hospital mortality was similar in the
two groups (2.9% versus 9.3%, P = 0.122). However, group A had a
significantly shorter operation time (279.24±39.03 versus 298.24±45.90,
P=0.008), lower intraoperative blood loss (240.48±96.75 versus
353.70±189.80, P<0.001), and reduced intraoperative transfusion
requirement of red blood cells (2.61±1.18 versus 6.05±1.86, P<0.001).
The postoperative suction drainage within 24 hours in group A was
significantly decreased (243.24±201.52 versus 504.22±341.08,P=0.002).
The incidence of postoperative acute kidney injury (AKI) in group A was
lower than that in group B (3.8% versus 14.8%, P =0.023). Similarly,
the incidence of postoperative hepatic insufficiency in group A was
lower than that in group B (1.9% versus 9.3%, P =0.045). In group A,
the mechanical ventilation time was shorter (47.68±28.61 versus
118.21±173.16, P=0.004) along with reduced ICU stay time (4.06±1.18
versus 8.09±9.42, P=0.003), and postoperative hospitalization days
(19.20±14.60 versus 23.50±7.56, P=0.004). Conclusion:
Preoperative administration of human fibrinogen in patients undergoing
ATAAD surgery can effectively reduce the intraoperative blood loss,
blood transfusion amount, shorten the operation time, reduce
postoperative complications, and improve the early prognosis of
patients, in addition to being highly safe.