Early Postoperative Thrombocytopenia Following Cardiac Surgery

Year 2023, Volume: 76 Issue: 3, 265 - 270, 30.06.2024

Gülen Sezer Alptekin Orkut Güçlü Serhat Hüseyin Volkan Yüksel Suat Canbaz Turan Ege

Abstract

Objectives: There are various risk factors which make the cardiac surgery patients prone to thrombocytopenia such as the effects of cardiopulmonary bypass procedure, anticoagulant administration, bleeding diathesis, blood product transfusions and hypothermia. However the clinical and prognostic value of early thrombocytopenia soon after cardiac surgery is less studied previously and is the objective of our study.

Methods: In this cross-sectional study we evaluated cardiac surgery patients who were operated within 6 months period in our hospital electively. Thrombocytopenia was defined as a platelet count under 150,000/μL. The peroperative variables, prognostic scores according to the Sequential Organ Failure Assesment (SOFA), length of stay, mortality and adverse events during hospital stay were investigated.

Results: Thrombocytopenia was observed in 33.05% of all patients. The mean cross-clamping time was prolonged and the total mediastinal drainage volume was excessive in thrombocytopenia group. All-cause infection, pulmonary and renal dysfunction rates were higher, SOFA scores were increasing at 24th and 48th hours, and length of stay in hospital and intensive care unit were prolonged in this group.

Conclusion: Thrombocytopenia may be associated with multiple organ dysfunction and further infections; and may be regarded as a remarkable finding of poor prognosis and prolonged length of stay after cardiac surgery in early period. Hemorrhage and prolonged cross clamping time are the significant risk factors associated with thrombocytopenia in our study. Therefore an appropriate hemostatic approach and brief cross clamping time may be considered as preventive strategies to reduce thrombocytopenia following cardiac surgery.

Key Words: Thrombocytopenia, Coronary Artery Bypass, Postoperative Thrombocytopenia, Postoperative Prognosis

Keywords

Thrombocytopenia , Coronary Artery Bypass , Postoperative Thrombocytopenia , Postoperative Prognosis

Ethical Statement

The study was approved by the local Ethics Commitee (TUTF-GOKAEK 2013/21).

Supporting Institution

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Project Number

-

Thanks

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Kardiyak Cerrahi Sonrası Erken Postoperatif Trombositopeni

Abstract

Amaç: Kardiyopulmoner baypas prosedürünün etkileri, antikoagülan uygulanması, kanama diyatezi, kan ürünü transfüzyonu ve hipotermi gibi çeşitli risk faktörleri kalp cerrahisi hastalarını trombositopeniye yatkın hale getirmektedir. Kalp cerrahisi sonrası erken trombositopeninin klinik ve prognostik önemi ise önceki çalışmalarda daha az incelenmiştir ve çalışmamızın temel konusunu oluşturmaktadır.

Gereç ve Yöntem: Bu kesitsel çalışmada 6 ay içerisinde hastanemizde elektif olarak kalp cerrahisi uygulanan hastalar incelendi. Trombosit sayısının 150.000/μL altında olması trombositopeni olarak kabul edildi. Peroperatif değişkenler, Ardışık Organ Yetmezliği Değerlendirmesi’ne (SOFA) göre prognostik skorlar, yatış süresi, hastane yatışı sırasındaki mortalite ve ek olaylar incelendi.

Bulgular: Hastaların %33,05’inde trombositopeni görüldü. Trombositopeni grubunda ortalama kros klemp süresi uzamış ve toplam mediastinal drenaj miktarı artmıştı. Bu grupta tüm nedenlere bağlı enfeksiyonlar, pulmoner ve renal disfonksiyon oranları fazla, SOFA skorları 24. ve 48. saatlerde yüksek, yoğun bakım ve hastane yatış süreleri daha uzun olmuştu.

Sonuç: Kalp cerrahisi sonrası erken dönemde trombositopeninin, multiorgan yetmezliği, gelişebilecek enfeksiyonlar, kötü prognoz ve uzamış yatış süresiyle ilişkili olabileceği gözlenmiştir. Çalışmamızda kanama ve uzamış kros klemp süresinin trombositopeniyle ilişkili anlamlı risk faktörleri olduğu saptanmıştır. Bu nedenle uygun hemostatik yaklaşım ve kros klemp süresinin kısa tutulmasının kalp cerrahisi sonrası trombositopeniyi azaltabilecek önlemler olabileceğini düşünmekteyiz.

Anahtar Kelimeler: Trombositopeni, Koroner Baypas, Postoperatif Trombositopeni, Postoperatif Prognoz

Keywords

Trombositopeni , Koroner Baypas , Postoperatif Trombositopeni , Postoperatif Prognoz

Ethical Statement

The study was approved by the local Ethics Commitee (TUTF-GOKAEK 2013/21).

Supporting Institution

-

Project Number

-

Thanks

-

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