Trombocitopenia em cirurgia cardíaca: importância diagnóstica e prognóstica

Rezende, Ederlon; Morais, Gustavo R.; Silva, João Manoel da; Oliveira, Amanda Maria Ribas Rosa de; Souza, Jose Marconi Almeida; Toledo, Diogo Oliveira; Richter, Ivo; Brandão, Enock Meira

doi:10.1590/s0102-76382011000100011

Cited by 10 publications

(4 citation statements)

References 30 publications

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“…for post-operative determinants, thrombocytopenia and IABP were associated with 30-day mortality after CABG. Post-operative thrombocytopenia increased the risk of 30-day mortality after CABG by 3.99-fold, consistent with the results of the previous studies by Kertai et [20], [21], [22]. Moreover, determinants such as the duration of aortic clamping, cardiopulmonary bypass, and post-operative IABP were previously reported to increase the risk of thrombocytopenia [20].…”

Section: Assupporting

confidence: 89%

Pre-operative, Intraoperative, and Post-operative Determinants Associated with 30-day Mortality Post-Coronary Artery Bypass Graft: A Retrospective Cohort Study

Rinaldi

Sudaryo

Mansjoer

2022

Open Access Maced J Med Sci

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Background: Various determinants of 30-day mortality risk in CABG patients have been formulated into certain scoring models such as the EuroSCORE and ACEF model. However, these models only consider preoperative parameters while excluding intraoperative, postoperative, and perioperative parameters. Currently, the prior research has increasingly emphasized the role of these excluded parameters as determinants of post-CABG mortality. Furthermore, there are differences in mortality rate of CABG procedures in Indonesia when compared with other countries. Hence, this study aimed to identify preoperative, intraoperative, and postoperative determinants of 30-day mortality after CABG surgery in Indonesian population. Methods: In this retrospective cohort study, secondary data were obtained from the medical records of 263 patients aged ≥ 18 years who underwent CABG at a single center in Indonesia during the year 2012–2015. Selected preoperative, intraoperative, postoperative, and perioperative determinants were analyzed in both bivariate and multivariate Cox regression models to identify determinants associated with 30-day mortality. Results: The 30-day mortality rate after CABG was 11.8%. Multivariate analysis identified neurological dysfunction (HR 6.16; 95% CI 2.42-15.66), renal impairment (HR 3.9; 95% CI 1.46-10.38), left ventricle dysfunction (HR 3.53;95% CI 1.55-8.03), aortic clamp duration (HR 3.7;95% CI 1.53-8.96), surgery duration (HR 3.85;95% CI 1.39-10.70), postoperative thrombocytopenia (HR 3.99;95% CI 1.72-9.23), and postoperative intra-aortic balloon pump (HR 10.98; 95% CI 4.77-25.28) as significant determinants associated with 30-day mortality after CABG Conclusions: Neurological dysfunction, renal impairment, left ventricle dysfunction, aortic clamp duration, surgery duration, postoperative thrombocytopenia, and postoperative intra-aortic balloon pump were independent determinants for 30-day mortality after CABG.

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Section: Assupporting

confidence: 89%

Pre-operative, Intraoperative, and Post-operative Determinants Associated with 30-day Mortality Post-Coronary Artery Bypass Graft: A Retrospective Cohort Study

Rinaldi

Sudaryo

Mansjoer

2022

Open Access Maced J Med Sci

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“… 1 There is a risk of developing thrombocytopenia in 35–65% of the patients who undergo cardiac surgery. 2 …”

Section: Introductionmentioning

confidence: 99%

A case of thrombocytopenia associated with the use of hydroxychloroquine following open heart surgery

Demir

Öçal

Abanoz

et al. 2014

International Journal of Surgery Case Reports

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“…It has been reported that approximately 35–65% of patients undergoing cardiac surgery experience thrombocytopenia, typically during the first 3–4 days post-surgery [ 18 , 23 ]. The average decrease in platelet count from baseline to immediately after cardiac surgery is 45.0–52.7% [ 18 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Association between postoperative nadir platelet count and postoperative cardiovascular complications following septal myectomy in patients with hypertrophic cardiomyopathy: a retrospective cohort study

Fan,

Lu,

Wang

et al. 2024

BMC Cardiovasc Disord

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Background Platelet count is associated with cardiovascular risk and mortality in several cardiovascular diseases, but the association of the nadir platelet counts post-septal myectomy with the cardiovascular complication risk in hypertrophic obstructive cardiomyopathy patients remains unclear. Methods This retrospective cohort study reviewed all adult patients who underwent septal myectomy at a single tertiary referral center over a 5-year period. Postoperative nadir platelet count was defined as the lowest platelet count in the first 4 postoperative days or until hospital discharge. The composite outcome included cardiovascular death, myocardial infarction, heart failure, malignant arrhythmia, cardiac tamponade, and major bleeding events within 30 days postoperatively. Univariable and multivariable logistic regression and restricted cubic spline models were used to assess the association between postoperative nadir platelet count and the 30-day postoperative cardiovascular complication risk. Results Among the 113 enrolled patients, 23 (20.4%) developed cardiovascular events within 30 days postoperatively. The incidence of postoperative cardiovascular complications was significantly higher in patients with a nadir platelet count ≤ 99 × 109/L than in those with a nadir platelet count > 99 × 109/L (33.3% vs. 7.1%, crude risk ratio: 4.67, 95% confidence interval: 1.69–12.85, P < 0.001). Multivariable logistic regression revealed that postoperative nadir platelet count was negatively associated with 30-day postoperative cardiovascular complications (adjusted odds ratio: 0.97; 95% confidence interval: 0.95–0.99; P = 0.005) and the association was linear (Pnonlinearity = 0.058) after full adjustment. The association between nadir platelet count and cardiovascular complications within 30 days post-surgery was consistent in all predefined subgroups (Pinteraction > 0.05). Conclusion The postoperative nadir platelet count was significantly associated with the 30-day post-myectomy risk of cardiovascular complications in hypertrophic obstructive cardiomyopathy patients. Trial registration This trial was registered at ClinicalTrials.gov (NCT04275544).

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Trombocitopenia em cirurgia cardíaca: importância diagnóstica e prognóstica

Cited by 10 publications

References 30 publications

Pre-operative, Intraoperative, and Post-operative Determinants Associated with 30-day Mortality Post-Coronary Artery Bypass Graft: A Retrospective Cohort Study

Pre-operative, Intraoperative, and Post-operative Determinants Associated with 30-day Mortality Post-Coronary Artery Bypass Graft: A Retrospective Cohort Study

A case of thrombocytopenia associated with the use of hydroxychloroquine following open heart surgery

Association between postoperative nadir platelet count and postoperative cardiovascular complications following septal myectomy in patients with hypertrophic cardiomyopathy: a retrospective cohort study

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