Factors associated with excessive bleeding after cardiac surgery: A prospective cohort study

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• 作者：Camila Takao Lopes ; RN ; PhD ; FNI^a ; ^b ; ^{camilatakao@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Evelise Fadini Reis Brunori ; RN ; PhD^c ; Agueda Maria Ruiz Zimmer Cavalcante ; RN ; PhD ; FNI^a ; Sue Ann Moorhead ; RN ; PhD^d ; Elizabeth Swanson ; RN ; PhD^d ; Juliana de Lima Lopes ; RN ; PhD^a ; Alba Lucia Bottura Leite de Barros ; RN ; PhD^a
• 关键词：Cardiac surgery ; Surgical procedures ; Hemorrhage ; Postoperative Hemorrhage ; Risk factors ; Thoracic surgery
• 刊名：Heart & Lung: The Journal of Acute and Critical Care
• 出版年：2016
• 出版时间：January-February 2016
• 年：2016
• 卷：45
• 期：1
• 页码：64-69.e2
• 全文大小：309 K

文摘

To identify factors associated with excessive bleeding (ExB) after cardiac surgery in adults.

Background

Excessive bleeding after cardiac surgery must be anticipated for implementation of timely interventions.

Methods

A prospective cohort study with 323 adults requiring open-chest cardiac surgery. Potential factors associated with ExB were investigated through univariate analysis and logistic regression. The accuracy of the relationship between the independent variables and the outcome was depicted through the receiver-operating characteristic (ROC) curve.

Results

The factors associated with ExB included gender, body mass index (BMI), preoperative platelet count, intraoperative heparin doses and intraoperative platelet transfusion. The ROC curve cut-off points were 26.35 for the BMI; 214,000 for the preoperative platelet count, and 6.25 for intraoperative heparin dose. This model had an accuracy = 77.3%, a sensitivity = 81%, and a specificity = 62%.

Conclusions

Male gender, BMI, preoperative platelet count, dose of intraoperative heparin >312.5 mg without subsequent platelet transfusion, are factors associated with ExB.