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Thorac Cardiovasc Surg 2022; 70(04): 306-313
DOI: 10.1055/s-0041-1741004
Original Cardiovascular

Risk Factors for High Blood Product Use in Patients with Stanford Type A Dissection

Myriam Schafigh
1   Department of Cardiac Surgery, Heart Center, University Hospital Bonn, Bonn, Germany
,
Armin Welz
1   Department of Cardiac Surgery, Heart Center, University Hospital Bonn, Bonn, Germany
,
Marwan Hamiko
1   Department of Cardiac Surgery, Heart Center, University Hospital Bonn, Bonn, Germany
,
Zaki Kohistani
1   Department of Cardiac Surgery, Heart Center, University Hospital Bonn, Bonn, Germany
,
Hendrik Treede
2   Department of Cardiac Surgery, University Hospital Mainz, Mainz, Germany
,
Chris Probst
1   Department of Cardiac Surgery, Heart Center, University Hospital Bonn, Bonn, Germany
› Author Affiliations Funding None.
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Abstract

Background Intraoperative and postoperative bleeding associated with allogeneic blood transfusion and reoperation is still a common and feared complication in patients undergoing surgery due to acute Type A Aortic Dissection (aTAAD). The aim of our study was to identify risk factors for higher transfusion rates.

Methods In this retrospective single center study we evaluated pre -, intra-, and postoperative data of 121 patients with aTAAD. Depending on the median of received packed red blood cells (PRBCs), patients were divided into Group A (<8 PRBC, n = 53) and Group B (≥8 PRBC n = 68). Statistical analyses (descriptive statistics, univariable and multivariable logistic regression) were performed using SPSS software 25.0. Statistical significance was assumed at p-value <0.05.

Results A total of 120 patients received a blood product during their perioperative course. Among others we identified age, hemorrhagic pericardial effusion, and dual antiplatelet therapy as preoperative risk factors, low rectal temperature as intraoperative risk factor and low body temperature, positive fluid balance, high lactate level and beginning development of acute renal failure as postoperative risk factors.

Conclusion Our study identifies several factors which predict a higher likelihood of bleeding and consecutive blood transfusion. Knowledge of these factors could influence the therapy to reduce transfusion requirements and lead to a targeted and more efficient use of coagulation products.

Keywords

aortic disease - blood transfusion - aortic surgery - complications

Meeting Presentation

Annual Meeting of Deutsche Gesellschaft für Thorax-, Herz-und Gefäßchirurgie February 29 to March 03, 2020.




Publication History

Received: 19 May 2021

Accepted: 06 September 2021

Article published online:
18 January 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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