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Risk Factors for Hypocoagulability After Cardiac Surgery: A Retrospective Study

Xuejie Li1, Ruiyu Wang1, Dawei Sun2

  • 1School of Anesthesiology, Weifang Medical University, Weifang, Shandong, China.

Clinical and Applied Thrombosis/Hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
|November 7, 2023
PubMed

Insights

Thromboelastography (TEG) revealed that lower intraoperative temperatures and higher fluid volumes during cardiac surgery with cardiopulmonary bypass (CPB) increase postoperative bleeding risk. Maintaining optimal temperature and fluid balance is crucial for patient recovery.

Area of Science:

  • Cardiology
  • Anesthesiology
  • Hematology

Background:

  • Postoperative bleeding is a significant complication following cardiac surgery.
  • Hemostatic disturbances can exacerbate bleeding risks in patients undergoing cardiopulmonary bypass (CPB).

Purpose of the Study:

  • To evaluate perioperative coagulative alterations using thromboelastography (TEG) in cardiac surgery patients.
  • To investigate the correlation between cardiac surgery factors and coagulation modifications.
  • To identify predictors of postoperative hypocoagulability and bleeding.

Main Methods:

  • Thromboelastography (TEG) was used to assess coagulation status.
  • Correlation analysis was performed between surgical factors and coagulation parameters.
  • Multivariate logistic and linear regression models identified independent predictors.

Main Results:

  • TEG-determined coagulation index significantly correlated with postoperative bleeding (P < .001).
  • Lower nadir intraoperative temperature, larger infused fluid volume, and longer CPB duration were associated with postoperative hypocoagulability.
  • Nadir intraoperative temperature and infused fluid volume linearly correlated with changes in coagulation index.

Conclusions:

  • Patients are susceptible to hypocoagulability after cardiac surgery, increasing bleeding risk.
  • Nadir intraoperative temperature is an independent predictor of postoperative hypocoagulability.
  • Optimizing intraoperative temperature and fluid management during CPB may mitigate hypocoagulability and reduce bleeding.

Keywords:
bleeding volumecardiac surgerycardiopulmonary bypasshypocoagulationperioperative coagulation functionthromboelastography

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