RETRACTED ARTICLE: Does coagulation differ between elderly and younger patients undergoing cardiac surgery?

Boldt, Joachim; Haisch, G.; Kumle, Bernhard; Brosch, Christian; Lehmann, Andreas; Werling, Christiane

doi:10.1007/s00134-002-1234-5

Cited by 22 publications

(15 citation statements)

References 20 publications

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“…Sex does not appear to affect TEG results in dogs, but the effect of age has not been evaluated in dogs to the authors' knowledge . In humans, reports of age‐related alterations in TEG results are conflicting, but age generally is considered to be weakly associated with hypercoagulability in the elderly . Neonates and children also may differ in their hemostatic profiles.…”

Section: Discussionmentioning

confidence: 97%

Hypercoagulability in Dogs with Protein‐Losing Nephropathy as Assessed by Thromboelastography

Lennon

Hanel

Walker

et al. 2013

Veterinary Internal Medicne

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Background: Dogs with protein-losing nephropathy (PLN) are at risk of thromboembolic disease, but the mechanism leading to hypercoagulability and the population of dogs at risk are unknown.Objectives: To characterize thromboelastography (TEG) and its association with serum albumin (SALB), UPC, and antithrombin activity in dogs with PLN.Animals: Twenty-eight client-owned dogs with PLN (urine protein:creatinine ratio [UPC] > 2.0) and 8 control dogs were prospectively enrolled in this observational study.Methods: TEG parameters, antithrombin activity, serum biochemical profiles, and UPC were measured. TEG analyses were run in duplicate with kaolin activation; reaction time (R), clot formation time (K), a-angle (a), maximal amplitude (MA), and global clot strength (G) were analyzed.Results: Dogs with PLN had lower K (P = .004), and higher a (P = .001), MA (P < .001), and G (P < .001) values than controls. No significant correlation between TEG parameters and UPC, SALB, or antithrombin was noted. Twelve PLN dogs (42.8%) were azotemic and 19 (67.8%) were hypoalbuminemic (SALB < 3.0 g/dL); 11 had SALB < 2.5 g/dL.Conclusions and Clinical Importance: These results indicate that dogs with PLN have TEG values that demonstrate hypercoagulability compared with a control population but that antithrombin, SALB, or UPC cannot be used in isolation to predict this result. A comprehensive evaluation of the coagulation system in individual patients may be necessary to predict the point at which anti-thrombotic therapy is indicated.

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Section: Discussionmentioning

confidence: 97%

Hypercoagulability in Dogs with Protein‐Losing Nephropathy as Assessed by Thromboelastography

Lennon

Hanel

Walker

et al. 2013

Veterinary Internal Medicne

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“…Recent reports raised concerns regarding blood collection site (Manspeizer et al, 2001), sample stability (Camenzind et al, 2000;Vig et al, 2001;Rajwal, Richards & O'Meara, 2004) and repeat sampling (Vig et al, 2001;Zambruni et al, 2004). In addition differences related to patient age (Pivalizza et al, 2001;Boldt et al, 2002;Ng, 2004) and gender (Gorton et al, 2000) have been reported.…”

Section: Standardizationmentioning

confidence: 99%

Thrombelastography/thromboelastometry

2005

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The term thrombelastograph (TEG) was used to describe the trace produced from the measurement of the viscoelastic changes associated with fibrin polymerization. Recently the term rotational thromboelastometry has been applied to the output of the ROTEM instrument. Since its first description in 1948, the TEG/ROTEM has been successfully used in the near patient assessment of haemostasis. The greatest use has been the application of TEG-guided transfusion of blood components in hepatic and more widely in cardiac surgery. Recent years have seen a renewed interest in the technology with applications for both pharmaceutical monitoring and patient screening being described. The present review gives a broad overview of the developments and applications related to thrombelastography/thromboelastometry.

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“…Elderly patients presenting for cardiac surgery are often anaemic, and have moderately altered coagulation before and after surgery. The reasons for this are unknown [9–12]. Previous studies have shown that approximately 61% of the patients undergoing cardiac surgery will undergo transfusion [13–15].…”

mentioning

confidence: 99%

Survival and length of stay following blood transfusion in octogenarians following cardiac surgery

et al. 2010

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SummaryOur aim was to assess if peri-operative blood transfusion is an independent risk factor for mortality and morbidity in the elderly. We report the results of a cohort study of all patients aged 80 or more on the day of their emergency or elective cardiac surgery (n = 874), using routinely collected data from January 2003 to November 2007. The primary outcome was all-cause mortality in hospital. The secondary outcomes were duration of stay in the intensive care unit (ICU) and overall hospital stay. Confounding variables were used to build up a risk model using a multivariable logistic regression analysis, and blood transfusion was added to assess whether it had additional predictive value for hospital mortality. Patients were divided into three groups: (i) transfusion of 0-2 units of red blood cells; (ii) transfusion of > 2 units of red blood cells and (iii) transfusion of red blood cells plus other clotting products. The strongest independent predictors of hospital death were logistic EuroSCORE and body mass index. After inclusion of these two variables, the odds ratio for transfusion remained significant. Relative to 0-2 units, the odds ratio for > 2 units was 6.80 (95% CI 2.46-18.8), and for other additional blood products was 14.4 (95% CI 5.34-37.

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RETRACTED ARTICLE: Does coagulation differ between elderly and younger patients undergoing cardiac surgery?

Abstract: Elderly cardiac surgery patients already showed moderately altered coagulation prior to surgery. Thus elderly patients may be at risk of developing postoperative alterations in hemostasis on the ICU. The exact reasons for the impaired coagulation in the elderly remains to be determined.

Cited by 22 publications

References 20 publications

Hypercoagulability in Dogs with Protein‐Losing Nephropathy as Assessed by Thromboelastography

Hypercoagulability in Dogs with Protein‐Losing Nephropathy as Assessed by Thromboelastography

Thrombelastography/thromboelastometry

Survival and length of stay following blood transfusion in octogenarians following cardiac surgery

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