{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T08:24:21Z","timestamp":1787214261741,"version":"build-2736575974"},"reference-count":17,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Appl Thromb Hemost"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Surgery for acute type A aortic dissection (ATAAD) may expose patients to major bleeding and massive transfusion. We assessed the impact of coagulopathy upon admission, before surgery, on perioperative transfusion requirements and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective single-center study including consecutive patients undergoing emergency surgical aortic repair for ATAAD from August 2017 to July 2022 in a tertiary referral center. We assessed the association between coagulopathy at hospital admission, defined by an International Normalized Ratio (INR) &gt;1.2, and perioperative transfusion requirements and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 133 included patients operated for ATAAD, 36 (27%) had coagulopathy at admission. Compared with non-coagulopathic patients, they more frequently presented with preoperative shock and had higher lactate levels at admission. Coagulopathic patients received more intraoperative red blood cell (RBC) transfusions (4 [1.7-7] vs 2 [0-4] units, p=0.009), fresh frozen plasma (FFP) (4 [2.8-6] vs 3 [2-4] units, p=0.028), platelets (5.3 [3.7-8.2] vs 4 [3.2-5.5] x10\n                      <jats:sup>11<\/jats:sup>\n                      platelets, p=0.033), and fibrinogen concentrates (3 [2-3.3] vs 2 [1.5-3] g, p=0.019). They also required more RBC transfusion within 48 hours after surgery (5 [3-7] vs 3 [1-4] units, p=0.002) (primary endpoint). ROC analysis showed that INR &gt;1.2 had moderate discriminative ability for predicting intraoperative transfusion of \u22653 RBC units (AUROC 0.68), with high specificity (84%) but limited sensitivity (36%). Postoperative complications were frequent and comparable between groups. Finally, in-hospital mortality rate was 25% in the coagulopathy group versus 16.5% in the group without coagulopathy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Admission coagulopathy in ATAAD was associated with increased perioperative transfusion requirements. Preoperative INR may contribute to early transfusion risk assessment, although its limited sensitivity precludes its use as a standalone predictive tool.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10760296261472639","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:47:26Z","timestamp":1786978046000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Coagulopathy at Admission on Perioperative Blood Transfusion in Acute Type A Aortic Dissection"],"prefix":"10.1177","volume":"32","author":[{"given":"Diane","family":"Zlotnik","sequence":"first","affiliation":[{"name":"AP-HP, European Georges Pompidou Hospital"},{"name":"Inserm, UMR_S970, Paris Cardiovascular Research Center, Team Endotheliopathy and Hemostasis Disorders, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Polge","sequence":"additional","affiliation":[{"name":"AP-HP, European Georges Pompidou Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8834-2488","authenticated-orcid":false,"given":"Georges","family":"Abi Abdallah","sequence":"additional","affiliation":[{"name":"AP-HP, European Georges Pompidou Hospital"},{"name":"Inserm, UMR_S970, Paris Cardiovascular Research Center, Team Endotheliopathy and Hemostasis Disorders, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Porte","sequence":"additional","affiliation":[{"name":"AP-HP, European Georges Pompidou Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willy","family":"Sutter","sequence":"additional","affiliation":[{"name":"AP-HP, European Georges Pompidou Hospital"},{"name":"Inserm, UMR_S970, Paris Cardiovascular Research Center, Team Endotheliopathy and Hemostasis Disorders, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"Bellenfant","sequence":"additional","affiliation":[{"name":"AP-HP, European Georges Pompidou Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Fran\u00e7ois","sequence":"additional","affiliation":[{"name":"AP-HP, European Georges Pompidou Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Godier","sequence":"additional","affiliation":[{"name":"AP-HP, European Georges Pompidou Hospital"},{"name":"Inserm, UMR_S970, Paris Cardiovascular Research Center, Team Endotheliopathy and Hemostasis Disorders, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01970-5"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.12945\/j.aorta.2017.16.034"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivw425"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2023.1294505"},{"key":"e_1_3_3_6_2","volume-title":"ESC Guidelines for the management of peripheral arterial and aortic diseases | European Heart Journal","year":"2024","unstructured":"2024 ESC Guidelines for the management of peripheral arterial and aortic diseases | European Heart Journal; Oxford Academic. https:\/\/academic.oup.com\/eurheartj\/article\/45\/36\/3538\/7738955"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.21037\/acs.2016.06.01"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2011.01.058"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000004710"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13019-017-0613-5"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2019.02.013"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-0134"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.09.022"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2010.03945.x"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.TA.0000069184.82147.06"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-021-02399-y"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2023.08.003"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.023956"}],"container-title":["Clinical and Applied Thrombosis\/Hemostasis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10760296261472639","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10760296261472639","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10760296261472639","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T07:48:53Z","timestamp":1787212133000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10760296261472639"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":17,"alternative-id":["10.1177\/10760296261472639"],"URL":"https:\/\/doi.org\/10.1177\/10760296261472639","relation":{},"ISSN":["1076-0296","1938-2723"],"issn-type":[{"value":"1076-0296","type":"print"},{"value":"1938-2723","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"article-number":"10760296261472639"}}