title: The Effect of Aspirin on Bleeding and Transfusion in Contemporary Cardiac Surgery.
abstract: OBJECTIVE
  Despite evidence that preoperative aspirin improves outcomes in cardiac surgery, recommendations for aspirin use are inconsistent due to aspirin's anti-platelet effect and concern for bleeding. The purpose of this study was to investigate preoperative aspirin use and its effect on bleeding and transfusion in cardiac surgery.
  
  
  METHODS
  This retrospective study involved consecutive patients (n=1571) who underwent CABG, valve, or combined CABG and valve surgery at a single center between March 2007 and July 2012. Of all patients, 728 met the inclusion criteria and were divided into two groups: those using (n=603) or not using (n=125) aspirin within 5 days of surgery. Data were collected on chest tube drainage, re-operation for bleeding, and transfusion of red blood cells (RBCs), fresh frozen plasma (FFP), and platelets.
  
  
  RESULTS
  No significant difference was observed between the two groups in chest tube drainage or re-operation for bleeding. An increase in patients transfused with RBCs was observed in the aspirin group (61.9 vs 51.2%, adjusted OR 1.77, p=0.027); however, among those transfused RBCs, no significant difference in mean units transfused or massive transfusion was observed. No significant difference was seen in transfusion requirement of FFP or platelets.
  
  
  CONCLUSIONS
  In patients undergoing CABG, valve, or combined CABG/valve surgery, preoperative aspirin, within 5 days of surgery, was associated with an increased probability of receiving an RBC transfusion. Preoperative aspirin was not associated with an increase in chest tube drainage, re-operation for bleeding complications, or transfusion of FFP or platelets.
authors.affiliation: Department of Anesthesiology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America.
authors.forename: Jordan E
authors.initials: JE
authors.lastname: Goldhammer
authors.affiliation: Division of Cardiology, Department of Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America.
authors.forename: Gregary D
authors.initials: GD
authors.lastname: Marhefka
authors.affiliation: Division of Biostatistics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America.
authors.forename: Constantine
authors.initials: C
authors.lastname: Daskalakis
authors.affiliation: Department of Anesthesiology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Berguson
authors.affiliation: Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America.
authors.forename: John E
authors.initials: JE
authors.lastname: Bowen
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America.
authors.forename: James T
authors.initials: JT
authors.lastname: Diehl
authors.affiliation: Department of Anesthesiology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America.
authors.forename: Jianzhong
authors.initials: J
authors.lastname: Sun
mesh_terms: D000368:Aged; D001241:Aspirin / Q000009:adverse effects*; D001803:Blood Transfusion; D001026:Coronary Artery Bypass; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D001241:Aspirin