title: Hawthorn Herb Increases the Risk of Bleeding after Cardiac Surgery: An Evidence-Based Approach.
abstract: OBJECTIVE
  Hawthorn extract consumption is becoming more widespread among the Jordanian population with cardiovascular disorders. We conducted this prospective observational longitudinal study to determine the impact of hawthorn extract on bleeding risk in patients who undergo cardiac surgery.
  
  
  METHODS
  A prospective observational study was performed on 116 patients who underwent cardiac surgery in the period between June 2014 and May 2015. Patients were divided into two groups: Group I (patients recently consumed hawthorn extract) and Group II (patients never consumed hawthorn extract). Endpoint measures included the rates of reopening to control bleeding, early mortality, duration of intensive care unit stay, total in-hospital stay period, and duration and amount of chest tube drainage.
  
  
  RESULTS
  Hawthorn patients had a significantly higher rate of postoperative bleeding necessitating take back to the operating room compared to the control group (10% versus 1%; P = .03) respectively. The overall mortality rate for group I and II was 4% and 0% respectively; P = .17. Chest tubes were kept in for longer times in group I compared to group II (54 ± 14.6 versus 49 ± 14.7 hours respectively; P = .01). Group I stayed longer in the intensive care unit compared to group II (24 versus 22 hours respectively; P = .01). The total in-hospital stay period was comparable between the two groups.
  
  
  CONCLUSIONS
  Hawthorn extract consumption does increase the potential for bleeding and the amount of chest tube output after cardiac surgery.
authors: Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.
authors: Abeer M
authors: AM
authors: Rababa'h
authors: Department of Cardiac Surgery, Queen Alia Heart Institute, Amman, Jordan.
authors: Salah E
authors: SE
authors: Altarabsheh
authors: Department of Cardiac Surgery, Queen Alia Heart Institute, Amman, Jordan.
authors: Osama
authors: O
authors: Haddad
authors: Department of Cardiovascular Surgery, Case Western Reserve University, Cleveland, Ohio, USA.
authors: Salil V
authors: SV
authors: Deo
authors: Department of Cardiac Surgery, Al-Mouwasat Hospital, Dammam, Saudi Arabia.
authors: Yagthan
authors: Y
authors: Obeidat
authors: Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.
authors: Sayer
authors: S
authors: Al-Azzam
mesh_terms: D000284:Administration, Oral; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002423:Cause of Death; D027825:Crataegus / Q000009:adverse effects*; D019317:Evidence-Based Medicine; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007597:Jordan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010936:Plant Extracts / Q000008:administration & dosage / Q000009:adverse effects*; D019106:Postoperative Hemorrhage / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends
chemical_list: D010936:Plant Extracts