Risk factors of major bleeding in patients undergoing off-pump coronary artery bypass grafting
10.3760/cma.j.issn.1001-4497.2018.05.009
- VernacularTitle:非体外循环冠状动脉旁路移植术围手术期严重出血相关危险因素分析
- Author:
Wei LIU
1
;
Ziwei XI
;
Ran DONG
;
Chengxiong GU
;
Lizhong SUN
;
Yue SONG
;
Yonghe GUO
;
Zhenxian YAN
;
Yujie ZHOU
Author Information
1. 100029,首都医科大学附属北京安贞医院心内科
- Keywords:
Coronary artery bypass grafting;
off pump;
Risk factors;
Perioperative;
Bleeding
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2018;34(5):298-302
- CountryChina
- Language:Chinese
-
Abstract:
Objective To identify the risk factors of major bleeding in patients undergoing off-pump coronary artery by-pass grafting( OPCAB) .Methods Data on coronary artery disease patients who underwent off-pump CABG between December 2009 and December 2014 were reviewed.Baseline characteristics were compared between patients with clopidogrel discontinua-tion ≥5 days and <5 days.Univariate and multivariate logistic regression analyses were performed to investigate the risk fac-tors of perioperative major bleeding.Major bleeding was defined as the Universal Definition of Perioperative Bleeding(UDPB) class 3 -4.Results A total of 3988 patients who underwent OPCAB were included in this study.Major bleeding rate was 9.23%(n=368).Multivariable regression analysis showed that female sex(OR=1.99, 95%CI:1.57-2.52), age(OR=1. 02, 95%CI:1.00-1.03), lower BMI(BMI≤25 kg/m2)(OR=1.40,95%CI:1.12-1.75), decreased GRF(GFR<60 ml/min)(OR=1.43,95%CI:1.01-2.02), decreased preoperative Hct(Hct <0.40)(OR =1.57, 95%CI: 1.23-1.99) and clopidogrel discontinuation <5 days(OR=1.97, 95%CI:1.58-2.44) conferred a higher risk of perioperative major bleeding during OPCABG.Conclusion Female, advanced age, lower BMI, decreased GRF, decreased preoperative Hct and clopi-dogrel discontinuation<5 days are independent risk factors of perioperatice major bleeding in patients undergoing OPCAB .Pre-dicting risk of major bleeding can help sugeons to optimize perioperative management .
