Risk Factors for Hypocoagulability After Cardiac Surgery: A Retrospective Study
Hemostatic disturbances after cardiac surgery can lead to excessive postoperative bleeding. Thromboelastography (TEG) was employed to evaluate perioperative coagulative alterations in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB), investigating the correlation between factors...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2023-11-01
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| Series: | Clinical and Applied Thrombosis/Hemostasis |
| Online Access: | https://doi.org/10.1177/10760296231209927 |
| _version_ | 1797634088026243072 |
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| author | Xuejie Li MD Ruiyu Wang MD Dawei Sun MD, PhD Yuanyuan Yao MD, PhD Tingting Wang MD, PhD Ge Luo MD Mingxia Liu MD Jingpin Xu MD Zhenzhen Cheng MD, PhD Qi Gao MD Ying Wang MD Chaomin Wu MD Guangxin Xu MD Tao Lv MD Jingcheng Zou MD Min Yan MD, PhD |
| author_facet | Xuejie Li MD Ruiyu Wang MD Dawei Sun MD, PhD Yuanyuan Yao MD, PhD Tingting Wang MD, PhD Ge Luo MD Mingxia Liu MD Jingpin Xu MD Zhenzhen Cheng MD, PhD Qi Gao MD Ying Wang MD Chaomin Wu MD Guangxin Xu MD Tao Lv MD Jingcheng Zou MD Min Yan MD, PhD |
| author_sort | Xuejie Li MD |
| collection | DOAJ |
| description | Hemostatic disturbances after cardiac surgery can lead to excessive postoperative bleeding. Thromboelastography (TEG) was employed to evaluate perioperative coagulative alterations in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB), investigating the correlation between factors concomitant with cardiac surgery and modifications in coagulation. Coagulation index as determined by TEG correlated significantly with postoperative bleeding at 24-72 h after cardiac surgery ( P < .001). Among patients with a normal preoperative coagulation index, those with postoperative hypocoagulability showed significantly lower nadir temperature ( P = .003), larger infused fluid volume ( P = .003), and longer CPB duration ( P = .033) than those with normal coagulation index. Multivariate logistic regression showed that nadir intraoperative temperature was an independent predictor of postoperative hypocoagulability (adjusted OR: 0.772, 95% CI: 0.624-0.954, P = .017). Multivariate linear regression demonstrated linear associations of nadir intraoperative temperature ( P = .017) and infused fluid volume ( P = .005) with change in coagulation index as a result of cardiac surgery. Patients are susceptible to hypocoagulability after cardiac surgery, which can lead to increased postoperative bleeding. Ensuring appropriate temperature and fluid volume during cardiac surgery involving CPB may reduce risk of postoperative hypocoagulability and bleeding. |
| first_indexed | 2024-03-11T12:02:53Z |
| format | Article |
| id | doaj.art-a032e22d5bf647deada420b26f449122 |
| institution | Directory Open Access Journal |
| issn | 1938-2723 |
| language | English |
| last_indexed | 2024-03-11T12:02:53Z |
| publishDate | 2023-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical and Applied Thrombosis/Hemostasis |
| spelling | doaj.art-a032e22d5bf647deada420b26f4491222023-11-07T23:03:28ZengSAGE PublishingClinical and Applied Thrombosis/Hemostasis1938-27232023-11-012910.1177/10760296231209927Risk Factors for Hypocoagulability After Cardiac Surgery: A Retrospective StudyXuejie Li MD0Ruiyu Wang MD1Dawei Sun MD, PhD2Yuanyuan Yao MD, PhD3Tingting Wang MD, PhD4Ge Luo MD5Mingxia Liu MD6Jingpin Xu MD7Zhenzhen Cheng MD, PhD8Qi Gao MD9Ying Wang MD10Chaomin Wu MD11Guangxin Xu MD12Tao Lv MD13Jingcheng Zou MD14Min Yan MD, PhD15 School of Anesthesiology, , Weifang, Shandong, China School of Anesthesiology, , Weifang, Shandong, China Department of Anesthesiology, Second Affiliated Hospital, , Hangzhou, Zhejiang, China Department of Anesthesiology, Second Affiliated Hospital, , Hangzhou, Zhejiang, China Department of Anesthesiology, Second Affiliated Hospital, , Hangzhou, Zhejiang, China Department of Anesthesiology, Second Affiliated Hospital, , Hangzhou, Zhejiang, China Department of Anesthesiology, Second Affiliated Hospital, , Hangzhou, Zhejiang, China Department of Anesthesiology, Second Affiliated Hospital, , Hangzhou, Zhejiang, China Department of Anesthesiology, Second Affiliated Hospital, , Hangzhou, Zhejiang, China Department of Anesthesiology, Second Affiliated Hospital, , Hangzhou, Zhejiang, China Department of Anesthesiology, Second Affiliated Hospital, , Hangzhou, Zhejiang, China Department of Anesthesiology, Second Affiliated Hospital, , Hangzhou, Zhejiang, China Department of Anesthesiology, Second Affiliated Hospital, , Hangzhou, Zhejiang, China Department of Anesthesiology, Second Affiliated Hospital, , Hangzhou, Zhejiang, China Department of Anesthesiology, Second Affiliated Hospital, , Hangzhou, Zhejiang, China Department of Anesthesiology, Second Affiliated Hospital, , Hangzhou, Zhejiang, ChinaHemostatic disturbances after cardiac surgery can lead to excessive postoperative bleeding. Thromboelastography (TEG) was employed to evaluate perioperative coagulative alterations in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB), investigating the correlation between factors concomitant with cardiac surgery and modifications in coagulation. Coagulation index as determined by TEG correlated significantly with postoperative bleeding at 24-72 h after cardiac surgery ( P < .001). Among patients with a normal preoperative coagulation index, those with postoperative hypocoagulability showed significantly lower nadir temperature ( P = .003), larger infused fluid volume ( P = .003), and longer CPB duration ( P = .033) than those with normal coagulation index. Multivariate logistic regression showed that nadir intraoperative temperature was an independent predictor of postoperative hypocoagulability (adjusted OR: 0.772, 95% CI: 0.624-0.954, P = .017). Multivariate linear regression demonstrated linear associations of nadir intraoperative temperature ( P = .017) and infused fluid volume ( P = .005) with change in coagulation index as a result of cardiac surgery. Patients are susceptible to hypocoagulability after cardiac surgery, which can lead to increased postoperative bleeding. Ensuring appropriate temperature and fluid volume during cardiac surgery involving CPB may reduce risk of postoperative hypocoagulability and bleeding.https://doi.org/10.1177/10760296231209927 |
| spellingShingle | Xuejie Li MD Ruiyu Wang MD Dawei Sun MD, PhD Yuanyuan Yao MD, PhD Tingting Wang MD, PhD Ge Luo MD Mingxia Liu MD Jingpin Xu MD Zhenzhen Cheng MD, PhD Qi Gao MD Ying Wang MD Chaomin Wu MD Guangxin Xu MD Tao Lv MD Jingcheng Zou MD Min Yan MD, PhD Risk Factors for Hypocoagulability After Cardiac Surgery: A Retrospective Study Clinical and Applied Thrombosis/Hemostasis |
| title | Risk Factors for Hypocoagulability After Cardiac Surgery: A Retrospective Study |
| title_full | Risk Factors for Hypocoagulability After Cardiac Surgery: A Retrospective Study |
| title_fullStr | Risk Factors for Hypocoagulability After Cardiac Surgery: A Retrospective Study |
| title_full_unstemmed | Risk Factors for Hypocoagulability After Cardiac Surgery: A Retrospective Study |
| title_short | Risk Factors for Hypocoagulability After Cardiac Surgery: A Retrospective Study |
| title_sort | risk factors for hypocoagulability after cardiac surgery a retrospective study |
| url | https://doi.org/10.1177/10760296231209927 |
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