Kremke Michael, Hansen Malene Kærslund, Christensen Steffen, Tang Mariann, Andreasen Jan Jesper, Jakobsen Carl-Johan
Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Eur J Cardiothorac Surg. 2015 Nov;48(5):e102-9. doi: 10.1093/ejcts/ezv297. Epub 2015 Sep 2.
Previous research suggests that platelet transfusion is associated with adverse events after coronary artery bypass grafting (CABG). The aim of the current analysis was to verify this hypothesis.
Data from 6745 consecutive patients undergoing CABG from 2006 through 2012 were collected. Patients receiving platelet transfusions intraoperatively or postoperatively in the intensive care unit were compared with control patients. To adjust for possible confounders, propensity score matching and conditional regression analyses were performed. Short-term outcomes were 30-day mortality, in-hospital myocardial infarction and stroke. Mid-term outcomes were 6-month mortality, and need for coronary angiography or repeat coronary revascularization within 6 months after surgery. Data were retrieved from the Western Denmark Heart Registry.
Using propensity scores, 982 patients exposed to platelets were matched with 982 control patients. Platelet transfusion was associated with a higher rate of postoperative coronary angiography (adjusted odds ratio 2.34, 95% confidence interval 1.15-4.76). There was no significant association between platelet transfusion and postoperative mortality, myocardial infarction, stroke and need for repeat coronary revascularization.
Platelet transfusion at the time of CABG is not associated with increased postoperative mortality, in-hospital myocardial infarction, stroke or need for repeat coronary revascularization.
先前的研究表明,冠状动脉旁路移植术(CABG)后血小板输注与不良事件相关。本分析的目的是验证这一假设。
收集了2006年至2012年连续6745例行CABG患者的数据。将术中或术后在重症监护病房接受血小板输注的患者与对照患者进行比较。为了调整可能的混杂因素,进行了倾向评分匹配和条件回归分析。短期结局为30天死亡率、住院期间心肌梗死和中风。中期结局为6个月死亡率,以及术后6个月内进行冠状动脉造影或再次冠状动脉血运重建的需求。数据取自丹麦西部心脏登记处。
使用倾向评分,982例接受血小板输注的患者与982例对照患者进行了匹配。血小板输注与术后冠状动脉造影的发生率较高相关(调整后的优势比为2.34,95%置信区间为1.15-4.76)。血小板输注与术后死亡率、心肌梗死、中风及再次冠状动脉血运重建的需求之间无显著关联。
CABG时血小板输注与术后死亡率增加、住院期间心肌梗死、中风或再次冠状动脉血运重建的需求无关。