Association Between Postoperative Thrombocytopenia and Outcomes After Coronary Artery Bypass Grafting Surgery
Objectives: The effect of postoperative thrombocytopenia on adverse events among coronary artery bypass graft (CABG) patients remains unclear. This study aims to investigate the association between postoperative thrombocytopenia and perioperative outcomes of CABG.Methods: This is a retrospective stu...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2021-09-01
|
| Series: | Frontiers in Surgery |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2021.747986/full |
| _version_ | 1818357805538607104 |
|---|---|
| author | Jinghang Li Dongmin Yu Yuanyuan Song Iokfai Cheang Xiaowei Wang |
| author_facet | Jinghang Li Dongmin Yu Yuanyuan Song Iokfai Cheang Xiaowei Wang |
| author_sort | Jinghang Li |
| collection | DOAJ |
| description | Objectives: The effect of postoperative thrombocytopenia on adverse events among coronary artery bypass graft (CABG) patients remains unclear. This study aims to investigate the association between postoperative thrombocytopenia and perioperative outcomes of CABG.Methods: This is a retrospective study with MIMIC-III (Medical Information Mart for Intensive Care III) database. Adult patients who underwent CABG were included to analyze the impact of thrombocytopenia in patients' outcomes. Postoperative thrombocytopenia was defined as a platelet count <100 × 109/L on the first day after CABG surgery. A multivariable logistic regression analysis was utilized to adjust the effect of thrombocytopenia on outcomes for baseline and covariates, and to determine the association with outcomes.Results: A total of 4,915 patients were included, and postoperative thrombocytopenia occurred in 696 (14.2%) patients. Postoperative thrombocytopenia was not associated with increased 28-day mortality (OR 0.75; 95% CI 0.33–1.72; P = 0.496) or in-hospital mortality (OR 0.75; 95% CI 0.34–1.63; P = 0.463) after adjusting for confounders. Regarding the secondary outcomes, it was associated with a higher risk of a prolonged stay in the intensive care unit (OR 1.53; 95% CI 1.18–1.97; P = 0.001), prolonged hospital stays (OR 1.58; 95% CI 1.21–2.06; P = 0.001), prolonged mechanical ventilation time (OR 1.67; 95% CI 1.14–2.44; P = 0.009), and a trend toward increased occurrence of massive bleeding (OR 1.41; 95% CI 1.00–2.01; P = 0.054). There was no significant association between an increased risk of prolonged vasopressor use and the continuous renal replacement therapy rate.Conclusions: Postoperative thrombocytopenia was associated with prolonged ICU and hospital stays but not with increased perioperative mortality among CABG patients. |
| first_indexed | 2024-12-13T20:18:57Z |
| format | Article |
| id | doaj.art-3e58c981a70b41f69aac41809a8619ce |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-12-13T20:18:57Z |
| publishDate | 2021-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-3e58c981a70b41f69aac41809a8619ce2022-12-21T23:32:44ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2021-09-01810.3389/fsurg.2021.747986747986Association Between Postoperative Thrombocytopenia and Outcomes After Coronary Artery Bypass Grafting SurgeryJinghang Li0Dongmin Yu1Yuanyuan Song2Iokfai Cheang3Xiaowei Wang4Department of Cardiovascular Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Cardiovascular Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Cardiovascular Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Cardiovascular Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaObjectives: The effect of postoperative thrombocytopenia on adverse events among coronary artery bypass graft (CABG) patients remains unclear. This study aims to investigate the association between postoperative thrombocytopenia and perioperative outcomes of CABG.Methods: This is a retrospective study with MIMIC-III (Medical Information Mart for Intensive Care III) database. Adult patients who underwent CABG were included to analyze the impact of thrombocytopenia in patients' outcomes. Postoperative thrombocytopenia was defined as a platelet count <100 × 109/L on the first day after CABG surgery. A multivariable logistic regression analysis was utilized to adjust the effect of thrombocytopenia on outcomes for baseline and covariates, and to determine the association with outcomes.Results: A total of 4,915 patients were included, and postoperative thrombocytopenia occurred in 696 (14.2%) patients. Postoperative thrombocytopenia was not associated with increased 28-day mortality (OR 0.75; 95% CI 0.33–1.72; P = 0.496) or in-hospital mortality (OR 0.75; 95% CI 0.34–1.63; P = 0.463) after adjusting for confounders. Regarding the secondary outcomes, it was associated with a higher risk of a prolonged stay in the intensive care unit (OR 1.53; 95% CI 1.18–1.97; P = 0.001), prolonged hospital stays (OR 1.58; 95% CI 1.21–2.06; P = 0.001), prolonged mechanical ventilation time (OR 1.67; 95% CI 1.14–2.44; P = 0.009), and a trend toward increased occurrence of massive bleeding (OR 1.41; 95% CI 1.00–2.01; P = 0.054). There was no significant association between an increased risk of prolonged vasopressor use and the continuous renal replacement therapy rate.Conclusions: Postoperative thrombocytopenia was associated with prolonged ICU and hospital stays but not with increased perioperative mortality among CABG patients.https://www.frontiersin.org/articles/10.3389/fsurg.2021.747986/fullcoronary artery bypass graftingthrombocytopeniamortalityMIMIC-III databaseperioperation |
| spellingShingle | Jinghang Li Dongmin Yu Yuanyuan Song Iokfai Cheang Xiaowei Wang Association Between Postoperative Thrombocytopenia and Outcomes After Coronary Artery Bypass Grafting Surgery Frontiers in Surgery coronary artery bypass grafting thrombocytopenia mortality MIMIC-III database perioperation |
| title | Association Between Postoperative Thrombocytopenia and Outcomes After Coronary Artery Bypass Grafting Surgery |
| title_full | Association Between Postoperative Thrombocytopenia and Outcomes After Coronary Artery Bypass Grafting Surgery |
| title_fullStr | Association Between Postoperative Thrombocytopenia and Outcomes After Coronary Artery Bypass Grafting Surgery |
| title_full_unstemmed | Association Between Postoperative Thrombocytopenia and Outcomes After Coronary Artery Bypass Grafting Surgery |
| title_short | Association Between Postoperative Thrombocytopenia and Outcomes After Coronary Artery Bypass Grafting Surgery |
| title_sort | association between postoperative thrombocytopenia and outcomes after coronary artery bypass grafting surgery |
| topic | coronary artery bypass grafting thrombocytopenia mortality MIMIC-III database perioperation |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2021.747986/full |
| work_keys_str_mv | AT jinghangli associationbetweenpostoperativethrombocytopeniaandoutcomesaftercoronaryarterybypassgraftingsurgery AT dongminyu associationbetweenpostoperativethrombocytopeniaandoutcomesaftercoronaryarterybypassgraftingsurgery AT yuanyuansong associationbetweenpostoperativethrombocytopeniaandoutcomesaftercoronaryarterybypassgraftingsurgery AT iokfaicheang associationbetweenpostoperativethrombocytopeniaandoutcomesaftercoronaryarterybypassgraftingsurgery AT xiaoweiwang associationbetweenpostoperativethrombocytopeniaandoutcomesaftercoronaryarterybypassgraftingsurgery |