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Modifiable Risk Factors associated with Post-Operative Bleeding and transfusion requirements in Cardiac Surgery
Bahauddin Khan1, Mujahid Ul Islam2, Imtiaz Ahmad3
1Dr. Bahauddin Khan, FCPS. Assistant Professor, Department of Cardiothoracic Surgery, Rehman Medical Institute, Peshawar, Pakistan.
Insights
Optimizing pre-operative hemoglobin and post-operative platelet count can reduce bleeding and transfusion needs in open heart surgery patients. Proper pre-operative assessment is key to managing these modifiable factors.
Area of Science:
- Cardiovascular Surgery
- Transfusion Medicine
- Anesthesiology
Background:
- Bleeding and transfusion are significant concerns in patients undergoing open heart surgery (OHS).
- Identifying modifiable factors can improve patient outcomes and reduce complications.
Purpose of the Study:
- To determine modifiable factors associated with bleeding and transfusion in post-cardiac surgery patients.
- To identify key parameters for preventing excessive blood product use after OHS.
Main Methods:
- Retrospective study of 200 patients who underwent OHS from December 2018 to July 2021.
- Analysis of pre-operative hemoglobin levels and post-operative platelet counts.
- Correlation of these parameters with transfusion requirements.
Main Results:
- Patients with pre-operative hemoglobin < 10 g/dL showed an increased need for blood and blood product transfusions.
- Post-operative platelet counts varied, with a significant portion requiring transfusion.
- Higher pre-operative hemoglobin and appropriate post-operative platelet management are linked to reduced transfusion needs.
Conclusions:
- Pre-operative hemoglobin correction and post-operative platelet count management are significant, preventable factors in cardiac surgery.
- Thorough pre-operative patient assessment is crucial for optimizing these parameters.
- Addressing these factors can lead to better outcomes and reduced transfusion dependency.
Objectives:
In this study we determine the modifiable factors related to bleeding and transfusion in post-cardiac surgery patients who underwent open heart surgery.
Methods:
This is a retrospective study that include two hundred patients who had undergone open heart surgery (OHS) at Northwest General Hospital and Research Center from December 2018 to July 2021. Platelet count and hemoglobin level were measured in the pre-operative period.
Results:
This study included both male and female patients. Postoperative platelets were counted as follow: 50-100 x109 L in 3.0% cases, 101-150 x109 L seen in 27.5% cases, and >150 x 109 L in 69.5% cases which required transfusion. We have also reported the increased requirement of transfusion of blood and blood products in patients with pre-operative hemoglobin (Hb) < 10 g/dl.
Conclusion:
Correction of pre-op Hb, post-op platelet count and total bypass time are the significant and preventable parameters in patients undergoing cardiac surgery if proper pre-op assessment of the patient is performed.
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