Sonoclot analysis in elderly compared with younger patients undergoing coronary surgery

Area of Science:

• Cardiovascular Surgery
• Hemostasis and Thrombosis
• Point-of-Care Testing

Background:

• The Sonoclot analyzer offers rapid, point-of-care assessment of blood clotting mechanisms.
• Coronary artery bypass grafting (CABG) involves complex peri-operative hemostatic challenges.
• Age-related differences in hemostasis may impact surgical outcomes.

Purpose of the Study:

• To evaluate peri-operative hemostatic differences between elderly and younger patients undergoing CABG using repeated Sonoclot analyses.
• To determine if Sonoclot variables can predict post-operative bleeding after CABG.
• To correlate Sonoclot findings with other hemostatic assays.

Main Methods:

• A cohort of 25 elderly and 25 younger patients undergoing CABG was studied.
• Sonoclot analyses (sonACT, clot rate, time-to-peak, peak amplitude, R3) were performed pre-operatively, intra-operatively, and up to 20 hours post-operatively.
• Post-operative blood loss was measured and correlated with Sonoclot variables and other hemostatic assays.

Main Results:

• A significant difference in sonACT (a measure of clot formation) was observed between elderly and younger patients (P=0.018).
• No other Sonoclot variables differed significantly between the age groups.
• No significant correlations were found between Sonoclot variables and post-operative bleeding or other hemostatic markers.

Conclusions:

• Elderly patients undergoing CABG exhibit reduced hemostatic function, as indicated by sonACT.
• Repeated Sonoclot analysis did not identify specific hemostatic disturbances or predict post-operative bleeding in this patient population.
• The clinical utility of Sonoclot for predicting bleeding risk in CABG patients requires further investigation.