Activated coagulation in patients with shock due to ruptured abdominal aortic aneurysm.

BACKGROUND: Ruptured abdominal aortic aneurysm is associated with a high operative mortality. Postoperative thrombosis related complications are common, a possible mechanism being activation of the coagulation system and endothelial stimulation. The aim of the present study was to investigate the coagulation activity preoperatively in patients with ruptured and nonruptured abdominal aortic aneurysm in relation to the clinical outcome with special regard to the influence of shock.

METHODS: Ninety-five patients with repair of infrarenal aortic aneurysm and forty-one controls without aneurysm matched by age, gender and smoking habits were studied. Thrombin-antithrombin (TAT), prothrombin fragment 1+2 (F 1+2), and von Willebrand factor antigen (vWFAg) were measured.

RESULTS: There were significantly higher levels of TAT, F 1+2, and vWFAg in patients operated for ruptured compared to nonruptured abdominal aortic aneurysm. The highest level of TAT and F 1+2 were detected in patients with rupture and shock.

CONCLUSION: The present data indicate a state of activated coagulation in patients with ruptured abdominal aortic aneurysm which is reinforced by shock.