Factors associated with excessive bleeding after cardiac surgery: A prospective cohort study.
OBJECTIVE
To identify factors associated with excessive bleeding (ExB) after cardiac surgery in adults.


BACKGROUND
Excessive bleeding after cardiac surgery must be anticipated for implementation of timely interventions.


METHODS
A prospective cohort study with 323 adults requiring open-chest cardiac surgery. Potential factors associated with ExB were investigated through univariate analysis and logistic regression. The accuracy of the relationship between the independent variables and the outcome was depicted through the receiver-operating characteristic (ROC) curve.


RESULTS
The factors associated with ExB included gender, body mass index (BMI), preoperative platelet count, intraoperative heparin doses and intraoperative platelet transfusion. The ROC curve cut-off points were 26.35 for the BMI; 214,000 for the preoperative platelet count, and 6.25 for intraoperative heparin dose. This model had an accuracy = 77.3%, a sensitivity = 81%, and a specificity = 62%.


CONCLUSIONS
Male gender, BMI, preoperative platelet count, dose of intraoperative heparin >312.5 mg without subsequent platelet transfusion, are factors associated with ExB.
Paulista Nursing School, Federal University of São Paulo (EPE-UNIFESP), São Paulo, SP, Brazil; Unversity Hospital, São Paulo University (HU-USP), São Paulo, SP, Brazil. Electronic address: camilatakao@hotmail.com.
Camila Takao
CT
Lopes
Dante Pazzanese Cardiology Institute (IDPC), São Paulo, SP, Brazil.
Evelise Fadini Reis
EF
Brunori
Paulista Nursing School, Federal University of São Paulo (EPE-UNIFESP), São Paulo, SP, Brazil.
Agueda Maria Ruiz Zimmer
AM
Cavalcante
College of Nursing, the University of Iowa, IA, USA.
Sue Ann
SA
Moorhead
College of Nursing, the University of Iowa, IA, USA.
Elizabeth
E
Swanson
Paulista Nursing School, Federal University of São Paulo (EPE-UNIFESP), São Paulo, SP, Brazil.
Juliana de Lima
Jde L
Lopes
Paulista Nursing School, Federal University of São Paulo (EPE-UNIFESP), São Paulo, SP, Brazil.
Alba Lucia Bottura Leite
AL
de Barros
D000368:Aged; D006348:Cardiac Surgical Procedures; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors; D012680:Sensitivity and Specificity
Cardiac surgery; Hemorrhage; Postoperative Hemorrhage; Risk factors; Surgical procedures; Thoracic surgery