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 9 publications

(3 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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“…In the general intensive care unit (ICU) scenario, thrombocytopenia may occur in up to 20% admissions, 35% of surgical hospitalizations and 45% of trauma admissions [1] . Considering cardiac surgery patients, thrombocytopenia is an extremely frequent finding, varying from 35% to 65% of all cases [10] , and patients after percutaneous coronary interventions (PCI) are also prone to develop major thrombocytopenia, i.e . <100.000/µL, in 2.4-9.2% of cases [11-13] .…”

Section: Introductionmentioning

confidence: 99%

Thrombocytopenia After Transcatheter Valvein- Valve Implantation: Prognostic Marker or Mere Finding?

Souza¹,

Paim²,

Viotto³

et al. 2018

Braz J Cardiovasc Surg

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ObjectiveTo analyze the behavior of platelets after transcatheter valve-in-valve implantation for the treatment of degenerated bioprosthesis and how they correlate with adverse events upon follow-up.MethodsRetrospective analysis of 28 patients who received a valve-in-valve implant, 5 in aortic, 18 in mitral and 5 in tricuspid positions. Data were compared with 74 patients submitted to conventional redo valvular replacements during the same period, and both groups' platelet curves were analyzed. Statistical analysis was conducted using the IBM SPSS Statistics(r) 20 for Windows.ResultsAll patients in the valve-in-valve group developed thrombocytopenia, 25% presenting mild (<150.000/µL), 54% moderate (<100.000/µL) and 21% severe (<50.000/µL) thrombocytopenia. The platelet nadir was on the 4th postoperative day for aortic ViV, 2nd for mitral and 3rd for tricuspid patients, with the majority of patients recovering regular platelet count. However, the aortic subgroup comparison between valve-in-valve and conventional surgery showed a statistically significant difference from the 7th day onwards, where valve-in-valve patients had more severe and longer lasting thrombocytopenia. This, however, did not translate into a higher postoperative risk. In our study population, postoperative thrombocytopenia did not correlate with greater occurrence of adverse outcomes and only normal preoperative platelet count could significantly predict a postoperative drop >50%.ConclusionAlthough thrombocytopenia is an extremely common finding after valve-in-valve procedures, the degree of platelet count drop did not correlate with greater incidence of postoperative adverse outcomes in our study population.

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Trombocitopenia em cirurgia cardíaca: importância diagnóstica e prognóstica

Cited by 9 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

Thrombocytopenia After Transcatheter Valvein- Valve Implantation: Prognostic Marker or Mere Finding?

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