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Influence of Human Factors on Coagulation Management in Cardiac Surgery: A Retrospective Analysis
Cyril Bachmann1, Teresa Di Primio1, Maria Sophia Gauger1
1Department of Anaesthesiology, Zurich City Hospital (Triemli Site), Zurich, Switzerland.
Insights
Anesthesiologist experience and on-call status did not influence coagulation product use in cardiac surgery. However, female anesthesiologists administered more products, though this finding was descriptive due to the small sample size.
Area of Science:
- Anesthesiology
- Transfusion Medicine
- Cardiac Surgery
Background:
- Coagulation product administration in cardiac surgery can vary.
- Factors influencing these decisions require investigation.
Purpose of the Study:
- To assess if anesthesiologist experience (cases/year), on-call status, or sex impacts coagulation product use during cardiac surgery.
Main Methods:
- Retrospective observational analysis at a single center.
- Included patients undergoing various cardiac surgeries.
- Examined data from 8 cardiac anesthesiologists.
Main Results:
- No significant difference in coagulation product transfusion rates based on anesthesiologist experience (≥52 vs. <52 cases/year).
- No difference in administration rates when anesthesiologists were on-call.
- The two female anesthesiologists exhibited the highest administration rates.
Conclusions:
- Anesthesiologist experience and on-call status are not associated with coagulation product administration in cardiac surgery.
- A descriptive observation noted higher administration rates among female anesthesiologists, requiring further study.
Objectives:
To determine if the administration of coagulation products in cardiac surgery depends on the anesthesiologist's exposure/number of cases per year, being on-call the same night as the surgery, or sex.
Design:
A retrospective observational analysis.
Setting:
A single-center study.
Participants:
Patients undergoing a wide range of cardiac surgeries.
Measurements And Main Results:
A total of 8 cardiac anesthesiologists anesthetized 578 patients. Our findings showed substantial variation in individual administration rates of coagulation products. However, the more-exposed half of cardiac anesthesiologists (≥52 cases/y) did not exhibit a different transfusion rate of coagulation products than the less-exposed half (<52 cases/y) (p = 0.23). Additionally, no difference was found in the rates of coagulation product administration when on-call (p = 0.96). Interestingly, the 2 highest rates of administered coagulation products were among the 2 female anesthesiologists in the team.
Conclusions:
No association between the number of cases performed per year and the administration of coagulation products was found. Likewise, being on-call showed no difference in the administration of coagulation products. The finding that the 2 female anesthesiologists had the 2 most liberal administration rates is noteworthy but, in regard to the small number of anesthesiologists, purely descriptive.
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