Κατεύθυνση Επείγουσα Νοσηλευτική
Library of the School of Health Sciences

2020-03-09

2020

Bonikou Maria

Αντωνία Καλογιάννη, Επίκουρη Καθηγήτρια, Τμήμα Νοσηλευτικής, ΠΑΔΑ
Γεώργιος Βασιλόπουλος, Επίκουρος Καθηγητής,Τμήμα Νοσηλευτικής, ΠΑΔΑ
Αναστασία Κοτανίδου, Καθηγήτρια Ιατρικής Σχολής, ΕΚΠΑ

Παράγοντες κινδύνου μετεγχειρητικής αιμορραγίας σε καρδιοχειρουργημένους ασθενείς

Greek

Risk factors of post operative bleeding in cardiac surgery patient

Introduction: Bleeding is the most common complication after cardiac surgery. Postoperative bleeding (PB) is treated with the administration of blood and with reoperation, but is accompanied by complications that adversely affect the postoperative course of patients.
Aim: The aim of the study was to investigate the factors associated with an increased risk of PB in patients after cardiac surgery. Secondary objective was to investigate factors associated with increased blood loss from chest drainage.
Material and Method
Study Design: This is a prospective observational study conducted at the Cardiothoracic Surgery Unit of the general hospital "The Evangelism". The study population included all patients who were admitted to the unit after cardiac surgery. Data collection lasted from March to September 2019 and was carried out with the creation of a form that included a) Demographic, social characteristics and habits of patients b) Preoperative characteristics c) Postoperative characteristics and d) Postoperative characteristics. PB was defined as 100ml of blood loss per hour from the chest drainage tube.
Results
The study sample consisted of 106 patients. The mean age of participants was 66.8 years (SD = 10 years) and 73% of them were male. 51.9% underwent CABG with a median number of grafts in 3 (interquartile range: 2-3). 15.1% had PB in the first 24 hours after surgery while median chest drainage was 350 ml / 12h (intermittent: 250-580ml / 12h). The mean duration of ischemia (p = 0.042) and cardiopulmonary bypass (CPB) (p = 0.031) was significantly higher in patients with PB. Multivariate logistic regression showed that measurements of PT [(OR 95% 0.41 (0.22-0.76)] and INR [(OR 95% 0.10 (0.03-0.97)]) by arrival at the cardiac surgery unit within the first 24 hours after surgery, and duration of CPB [(OR 95% 1.02 (1.00-1.03)] are independent of the incidence of PB. Additionally, gender of participants (p = 0.021), hypothermia during surgery, (p = 0.004) and CABG (p = 0.018) were found to be independent of blood less from chest drainage.
Conclusion. Prothrombin time, INR in the first 24 hours postoperatively, and duration of CPB were found to be independently associated with the occurrence of PB. Additional female gender, intraoperative hypothermia, and CABG were found to be independently related with increased blood loss from chest drainage. Knowledge of the factors associated with the increased bleeding is critical for nurses so they can provide prophylactic interventions and early postoperative treatment when needed.

Health Sciences

Risk factors, Post operative, Bleeding, Cardiac surgery

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Yes

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https://pergamos.lib.uoa.gr/uoa/dl/object/2898683