the utility of preoperative level of erythrocytosis in the prediction of postoperative blood loss and 30-day mortality in patients with tetralogy of fallot

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ID: 196967
2017
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Abstract
Background: Postoperative major bleeding is a relatively common complication of patients undergoing corrective surgery of tetralogy of Fallot (TOF). Life-threatening blood losses can lead to aggressive transfusions or reoperation. Little is known about the risk factors associated with a bleeding tendency in TOF patients. This study aimed to establish predictive models for postoperative blood loss and mortality in TOF patients. Methods: We conducted a retrospective observational study involving patients with TOF who were posted for corrective cardiac surgery in a single hospital between 2010 and 2015. Hospital records including sociodemographic, pre- and intra-operative characteristics were extracted. Postoperative blood loss (within 24 and 48 h) and 30-day mortality were the primary and secondary outcomes, respectively. Multivariate linear and logistic regression models were used to identify determinants of outcomes. Results: A total of 60 patients were included in this study. The median age was 1 year (interquartile range = 0.62–5) and the male to female ratio of 1.7:1. Mean postoperative blood loss within 24 h was 283 ± 212 mL. In multivariate linear regression, preoperative hematocrit (β = 6.63, P = 0.042) and duration of intraoperative oxygenator with CPB (β = 5.16, P = 0.025) were significantly correlated with postoperative blood loss within 24 h. After adjusting for sociodemographic, intra- and post-operative characteristics, preoperative hematocrit (odds ratio [OR] = 1.10, 95% confidence interval [CI] = 1.01–1.21), and postoperative red blood cell transfusions (OR = 3.88, 95% CI = 1.16–12.9) showed statistically significant association with 30-day mortality. The area under the receiver operating characteristic curve of the multivariable model was 0.863. Conclusions: Preoperative levels of erythrocytosis appear to predict postoperative blood loss and short-term mortality in TOF patients undergoing corrective surgery.
Reference Key
guevara2017annalsthe Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Jhon Harold Guevara, Andres Zorrilla-Vaca, Gloria C Silva-Gordillo
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Journal daru journal of pharmaceutical sciences
Year 2017
DOI
10.4103/aca.ACA_25_17
URL
http://www.annals.in/article.asp?issn=0971-9784;year=2017;volume=20;issue=2;spage=188;epage=192;aulast=Guevara
Keywords
Patient safety mortality predictors anesthesia blood loss

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