Antithrombin activity and outcomes in patients undergoing cardiac surgery with cardiopulmonary bypass.
We recently reported prospective results from a cohort of patients scheduled for elective cardiac surgery with cardiopulmonary bypass (CPB) in which most baseline clinical parameters of patients and surgery outcomes failed to demonstrate relationships with post-CPB antithrombin (AT) activity. In this extension study, a larger sample size (250 patients) was analyzed following general linear models. Patients' sociodemographic and pre-CPB clinical data as well as pre/post-CPB AT activity and outcomes were collected. There was a significant decrease of post-CPB AT activity (95.6 ± 13.7-64.6 ± 12.1%; P < 0.001). Univariate and multivariate analyses revealed that a decrease of approximately 1% post-CPB AT activity may be expected per 3 years increase in patient's age. Univariate analysis showed that post-CBP AT activity was inversely related to the need for transfusions, acute renal failure and occurrence of any complication (re-intervention, low cardiac output, arrhythmia, lung dysfunction, stroke, acute renal failure, mesenteric ischemia and re-hospitalization; P < 0.05). Multivariate analysis adjusted for age and pre-CPB AT did not show statistical significance. Odds ratio (OR) less than 1 was observed in most outcomes (0.8 on average), which suggested a reduction of the probability for an increase of 10% in post-CBP AT. Our results confirm the role of low postsurgery AT activity influencing outcomes in patients undergoing CPB.
Departamento de Anestesiología, Reanimación y Terapia del Dolor, Hospital Universitario La Ribera, Alzira-Valencia, Spain. vmuedra@hospital-ribera.com
Vicente
V
Muedra
Domingo
D
Barettino
Pilar
P
D'Ocón
Angel
A
Zuñiga
Lucrecia
L
Moreno
D058186:Acute Kidney Injury / Q000097:blood*; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D000990:Antithrombin III / Q000378:metabolism*; D001145:Arrhythmias, Cardiac / Q000097:blood*; D002303:Cardiac Output, Low / Q000097:blood*; D002315:Cardiopulmonary Bypass; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood*; D016896:Treatment Outcome
D000990:Antithrombin III