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Does a Platelet Transfusion Independently Affect Bleeding and Adverse Outcomes in Cardiac Surgery? | LitMetric

Does a Platelet Transfusion Independently Affect Bleeding and Adverse Outcomes in Cardiac Surgery?

Anesthesiology

From the Center for Clinical Transfusion Research, Sanquin/Leiden University Medical Center, Leiden, The Netherlands (F.M.A.v.H., E.K.H., J.G.v.d.B., A.B., L.M.G.v.d.W.); Department of Cardiac Anesthesiology and CU (P.M.J.R., N.J.M.v.d.M.) and Department of Cardiothoracic Surgery (M.B.), Amphia Hospital, Breda, The Netherlands; Department of Clinical Epidemiology (F.M.A.v.H., J.G.v.d.B.) and Department of Anesthesiology (E.L.A.v.D.), Leiden University Medical Center, The Netherlands; Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, The Netherlands (N.v.G.); Department of Anesthesia, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands (E.K.H.); and TIAS/Tilburg University, Tilburg, The Netherlands (N.J.M.v.d.M.).

Published: March 2017

AI Article Synopsis

  • This study investigates the impact of an early intraoperative platelet transfusion on bleeding and outcomes in cardiac surgery patients, analyzing data from 23,860 patients.
  • The intervention group (169 patients) was compared to a reference group (507 patients) who did not receive the transfusion, focusing on outcomes like bleeding, organ failure, and mortality.
  • Results indicated that while the transfusion group experienced less blood loss, they required more medical interventions post-surgery, such as vasoactive medications, prolonged mechanical ventilation, and additional blood products.

Article Abstract

Background: Conflicting results have been reported concerning the effect of platelet transfusion on several outcomes. The aim of this study was to assess the independent effect of a single early intraoperative platelet transfusion on bleeding and adverse outcomes in cardiac surgery patients.

Methods: For this observational study, 23,860 cardiac surgery patients were analyzed. Patients who received one early (shortly after cardiopulmonary bypass while still in the operating room) platelet transfusion, and no other transfusions, were defined as the intervention group. By matching the intervention group 1:3 to patients who received no early transfusion with most comparable propensity scores, the reference group was identified.

Results: The intervention group comprised 169 patients and the reference group 507. No difference between the groups was observed concerning reinterventions, thromboembolic complications, infections, organ failure, and mortality. However, patients in the intervention group experienced less blood loss and required vasoactive medication 139 of 169 (82%) versus 370 of 507 (74%; odds ratio, 1.65; 95% CI, 1.05 to 2.58), prolonged mechanical ventilation 92 of 169 (54%) versus 226 of 507 (45%; odds ratio, 1.47; 94% CI, 1.03 to 2.11), prolonged intensive care 95 of 169 (56%) versus 240 of 507 (46%; odds ratio, 1.49; 95% CI, 1.04 to 2.12), erythrocytes 75 of 169 (44%) versus 145 of 507 (34%; odds ratio, 1.55; 95% CI, 1.08 to 2.23), plasma 29 of 169 (17%) versus 23 of 507 (7.3%; odds ratio, 2.63; 95% CI, 1.50-4.63), and platelets 72 of 169 (43%) versus 25 of 507 (4.3%; odds ratio, 16.4; 95% CI, 9.3-28.9) more often compared to the reference group.

Conclusions: In this retrospective analysis, cardiac surgery patients receiving platelet transfusion in the operating room experienced less blood loss and more often required vasoactive medication, prolonged ventilation, prolonged intensive care, and blood products postoperatively. However, early platelet transfusion was not associated with reinterventions, thromboembolic complications, infections, organ failure, or mortality.

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Source
http://dx.doi.org/10.1097/ALN.0000000000001518DOI Listing

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