{"title":"How Important Impact of Low Level of Hematocrit Can Be on Outcome in Patients Undergoing Off Pump Coronary Artery Bypass Surgery?","authors":"Slavenka Straus, Ilirijana Haxhibeqiri Karabdic, Sanja Grabovica, Amel Hadzimehmedagic, Muhamed Djedovic, Edin Kabil, Tarik Selimovic, Nermir Granov","doi":"10.5455/aim.2023.31.102-106","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Cardiosurgical patients can be often anemic, and preoperative anaemia is associated with increased postoperative complications, as well as morbidity and mortality.</p><p><strong>Objective: </strong>The present study was conducted aiming to determine the influence of lower preoperative hematocrit values on the early postoperative recovery of patients undergoing elective off-pump coronary artery bypass grafting (OPCABG).</p><p><strong>Methods: </strong>Our retrospective study included 150 patients who underwent elective OPCABG surgery from September 2021 to December 2022 at the Clinic for Cardiovascular Surgery University of Sarajevo. Patients were divided into two groups, anemic and non-anemic, with anemia defined as hemoglobin level <130g/l males and <120g/l females. Study observed comorbidities and early postoperative data.</p><p><strong>Results: </strong>Overall prevalence of anemia in OPCABG patients was 36,6%, more frequent among older patients. Comorbidities as chronic obstructive pulmonary disease, hypertension, ejection fraction was quite similar in both groups, but body mass index was significantly higher in the group of patients with anemia (29.9% vs 28.4%). In early recovery period, vasopressors were more used in patients with anemia (63.6% vs 42.1%) and their doses were higher. Total drainage was higher in patients with anemia (744.45±45.72 ml vs 681.58±349.06 ml). Number of transfusions was higher in the group of patients with anemia: red blood cells (0.89±1.29 vs 0.29±0.84; p<0,05), fresh frozen plasma (0.65±1.13 vs 0.41±1.15; p<0,05) and platelets (0.11±0.57 vs 0,07±0.42; p>0,05). Duration of mechanical ventilation was longer in patients with anemia compared to non-anemic patients (623-91±259.83 minutes vs 469±191.13 minutes). Atrial fibrillation occurred more often in patients with anemia (12.7 vs 7.4%). Length of stay in the intensive care unit was without significant difference.</p><p><strong>Conclusion: </strong>Based on our findings, patients who underwent elective OPCABG with lower than normal hematocrit, needed more blood and blood products, more vasopressor drugs in higher doses, longer mechanical ventilation, all which can prolong the patient's recovery and increase the cost of treatment.</p>","PeriodicalId":7074,"journal":{"name":"Acta Informatica Medica","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3d/6a/AIM-31-102.PMC10498362.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Informatica Medica","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5455/aim.2023.31.102-106","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Cardiosurgical patients can be often anemic, and preoperative anaemia is associated with increased postoperative complications, as well as morbidity and mortality.
Objective: The present study was conducted aiming to determine the influence of lower preoperative hematocrit values on the early postoperative recovery of patients undergoing elective off-pump coronary artery bypass grafting (OPCABG).
Methods: Our retrospective study included 150 patients who underwent elective OPCABG surgery from September 2021 to December 2022 at the Clinic for Cardiovascular Surgery University of Sarajevo. Patients were divided into two groups, anemic and non-anemic, with anemia defined as hemoglobin level <130g/l males and <120g/l females. Study observed comorbidities and early postoperative data.
Results: Overall prevalence of anemia in OPCABG patients was 36,6%, more frequent among older patients. Comorbidities as chronic obstructive pulmonary disease, hypertension, ejection fraction was quite similar in both groups, but body mass index was significantly higher in the group of patients with anemia (29.9% vs 28.4%). In early recovery period, vasopressors were more used in patients with anemia (63.6% vs 42.1%) and their doses were higher. Total drainage was higher in patients with anemia (744.45±45.72 ml vs 681.58±349.06 ml). Number of transfusions was higher in the group of patients with anemia: red blood cells (0.89±1.29 vs 0.29±0.84; p<0,05), fresh frozen plasma (0.65±1.13 vs 0.41±1.15; p<0,05) and platelets (0.11±0.57 vs 0,07±0.42; p>0,05). Duration of mechanical ventilation was longer in patients with anemia compared to non-anemic patients (623-91±259.83 minutes vs 469±191.13 minutes). Atrial fibrillation occurred more often in patients with anemia (12.7 vs 7.4%). Length of stay in the intensive care unit was without significant difference.
Conclusion: Based on our findings, patients who underwent elective OPCABG with lower than normal hematocrit, needed more blood and blood products, more vasopressor drugs in higher doses, longer mechanical ventilation, all which can prolong the patient's recovery and increase the cost of treatment.
背景:心脏外科患者经常贫血,术前贫血与术后并发症增加以及发病率和死亡率相关。目的:本研究旨在确定术前较低的血细胞比容值对选择性非体外循环冠状动脉旁路移植术(OPCABG)患者术后早期恢复的影响。方法:我们的回顾性研究包括150例于2021年9月至2022年12月在萨拉热窝大学心血管外科诊所接受选择性OPCABG手术的患者。患者分为贫血和非贫血两组,贫血定义为血红蛋白水平。结果:OPCABG患者贫血的总体患病率为36.6%,在老年患者中更为常见。两组患者的合并症如慢性阻塞性肺病、高血压、射血分数相当相似,但贫血患者的体重指数明显高于贫血组(29.9% vs 28.4%)。在恢复期早期,贫血患者使用血管加压药较多(63.6% vs 42.1%),且剂量较高。贫血患者总引流量较高(744.45±45.72 ml vs 681.58±349.06 ml)。贫血组输血次数较高:红细胞(0.89±1.29 vs 0.29±0.84);p0, 05)。与非贫血患者相比,贫血患者机械通气持续时间更长(623-91±259.83分钟vs 469±191.13分钟)。房颤在贫血患者中更常见(12.7% vs 7.4%)。重症监护病房的住院时间没有显著差异。结论:根据我们的研究结果,选择性OPCABG患者的红细胞压积低于正常水平,需要更多的血液和血液制品,需要更多的血管加压药物和更高的剂量,需要更长时间的机械通气,这些都会延长患者的恢复时间,增加治疗成本。