The Correlation Between The Early Coagulation Function And Delayed Cerebral Ischemia After ASAH

ObjectiveTo investigate the correlation between the parameter of early coagulation function and the incidence of delayed cerebral ischemia after subarachnoid hemorrhage.To provide basis of early prediction and intervention for delayed cerebral ischemia in clinical treatment.MethodThe coagulation and TEG of 77 patients with aSAH within 24 hours from onset was analysed retrospectively and 22 cases of unruptured aneurysms(UIA)were cellected as matched group.aSAH patients were divided into the DCI group(38 cases)and No-DCI group(39 cases)to compare the clinical data,coagulogram and parameter of TEG.The multi-factor Logistic regression analysis was adopted to determine the risk factors,and Pearson analysis was used to analyse the correlation between risk factors and DCIResultCompared with the UIA,the values of DD,FDP in aSAH were significantly higher(P <0.01).Compared with the No-DCI,the values of DD,FDP,Fib,? and MA in DCI group were significantly higher,while lower than the values of R and K(P <0.01).The result of multiple-factor analysis shows that the parameter of D-D and modified Fisher grade was independent risk factors and positive correlation with the incidence of DCI.The parameter of D-D,FDP,Fib,? Angle,MA was significantly increased in high Fisher grade,while the parameter of R and K was obviously decreased.(P<0.05).ConclusionThrombelastograph is a novel tool to monitor the early coagulatory condtion of aSAH,as the compensation of routine coagulation.Hypercoagulability is associated with DCI after subarachnoid hemorrhage,whereas secondary hyperfibrinolysis lead to increased bleeding risk.Therefore,early monitoring of coagulation function can help predict the occurrence of DCI,as well as guide the therapies.