دورية أكاديمية
Impact of preoperative thrombocytopenia on the outcome after coronary artery bypass grafting
| العنوان: | Impact of preoperative thrombocytopenia on the outcome after coronary artery bypass grafting |
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| المؤلفون: | Nammas, Wail, Dalén, Magnus, Rosato, Stefano, Gherli, Riccardo, Reichart, Daniel, Gatti, Giuseppe, Onorati, Francesco, Faggian, Giuseppe, De Feo, Marisa, Bancone, Ciro, Chocron, Sidney, Khodabandeh, Sorosh, Santarpino, Giuseppe, Rubino, Antonino S, Maselli, Daniele, Nardella, Saverio, Salsano, Antonio, Gherli, Tiziano, Nicolini, Francesco, Zanobini, Marco, Saccocci, Matteo, Bounader, Karl, D'Errigo, Paola, Kiviniemi, Tuomas, Kinnunen, Eeva-Maija, Perrotti, Andrea, Airaksinen, Juhani, Mariscalco, Giovanni, Ruggieri, Vito G, Biancari, Fausto |
| المساهمون: | Nammas, Wail, Dalén, Magnu, Rosato, Stefano, Gherli, Riccardo, Reichart, Daniel, Gatti, Giuseppe, Onorati, Francesco, Faggian, Giuseppe, De Feo, Marisa, Bancone, Ciro, Chocron, Sidney, Khodabandeh, Sorosh, Santarpino, Giuseppe, Rubino, Antonino S, Maselli, Daniele, Nardella, Saverio, Salsano, Antonio, Gherli, Tiziano, Nicolini, Francesco, Zanobini, Marco, Saccocci, Matteo, Bounader, Karl, D'Errigo, Paola, Kiviniemi, Tuoma, Kinnunen, Eeva-Maija, Perrotti, Andrea, Airaksinen, Juhani, Mariscalco, Giovanni, Ruggieri, Vito G, Biancari, Fausto |
| سنة النشر: | 2018 |
| المجموعة: | Università degli Studi di Genova: CINECA IRIS |
| مصطلحات موضوعية: | Bleeding, cardiac surgery, coronary artery bypass grafting, platelet, surgery, thrombocytopenia |
| الوصف: | The impact of thrombocytopenia on postoperative bleeding and other major adverse events after cardiac surgery is unclear. This issue was investigated in a series of patients who underwent isolated coronary artery bypass grafting (CABG) from the prospective, multicenter E-CABG registry. Preoperative thrombocytopenia was defined as preoperative platelet count <150×109/L and it was considered moderate-severe when preoperative platelet count was <100×109/L. Multilevel mixed-effects regression analysis was performed to adjust the effect of thrombocytopenia on outcomes for baseline and operative covariates as well as for interinstitutional differences in patient-blood management. Among 7189 patients included in this analysis, 599 (8.3%) had preoperative thrombocytopenia. Patient with preoperative thrombocytopenia had an increased chest drainage output at 12h (mean, 519 vs. 456mL, adjusted coeff. 39, 95%CI 18-60) and rates of severe-massive bleeding (Universal Definition of Perioperative Bleeding (UDPB) severity grades 3-4: 12.7% vs. 8.1%, adjusted OR 1.47, 95%CI 1.11-1.93; E-CABG bleeding severity grades 2-3: 10.4% vs. 6.1%, adjusted OR 1.78, 95%CI 1.30-2.43). Thrombocytopenia was associated with an increased risk of hospital/30-day death (3.2% vs. 1.9%, adjusted OR 2.02, 95%CI 1.20-3.42), 1-year death (5.7% vs. 3.4%, adjusted HR 1.68, 95%CI 1.16-2.44), deep sternal wound infection (3.5% vs. 2.4%, adjusted OR 1.65, 95%CI 1.02-2.66), acute kidney injury (28.1% vs. 22.2%, OR 1.45, 1.18-1.78), and prolonged stay in the intensive care unit (mean, 3.6 vs 2.8days, adjusted coeff. 0.74, 95%CI 0.40-1.09). Similar results were observed in a subset of patients with moderate-severe thrombocytopenia (51 patients, 0.7%). In particular, these patients had a markedly higher rate of acute kidney injury (40%, adjusted OR, 1.94, 95%CI 1.05-3.57), resternotomy for bleeding (7.8%, adjusted OR 3.49, 95%CI 1.20-10.21), and severe-massive bleeding (UDPB severity grades 3-4: 23.5%, adjusted OR 3.08, 95%CI 1.52-6.22; E-CABG bleeding ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | ELETTRONICO |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/29676943; info:eu-repo/semantics/altIdentifier/wos/WOS:000463789600009; firstpage:480; lastpage:486; numberofpages:7; journal:PLATELETS; https://hdl.handle.net/11567/970415Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85045722867 |
| DOI: | 10.1080/09537104.2018.1466389 |
| الإتاحة: | https://doi.org/10.1080/09537104.2018.1466389Test https://hdl.handle.net/11567/970415Test |
| رقم الانضمام: | edsbas.83AC936F |
| قاعدة البيانات: | BASE |
| DOI: | 10.1080/09537104.2018.1466389 |
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