Impact of postoperative bleeding on short-term outcome in patients after orthotopic heart transplantation : a retrospective cohort study

2016
journal article
article
4
dc.abstract.enBACKGROUND: Orthotopic heart transplantation (HTX) remains the ultimate treatment option in patients with end-stage heart failure, endorsed by the European Society of Cardiology guidelines. The aim of the study is a complex evaluation of the postoperative bleeding after HTX and its influence on short-term outcome. MATERIAL AND METHODS: A retrospective cohort study consisted of 53 patients (4 females and 49 males, median age 52.5 years, IQR 17 years) who underwent HTX in the Department of Cardiovascular Surgery and Transplantology of John Paul II Hospital in Krakow between 2007 and 2014. RESULTS: The median chest tube output within first 24 hours after the surgery was 695 (550–870) mL. Bleeding decreased throughout the observation (p=0.000). The first postoperative hemoglobin level was a significant predictor of excessive blood loss (p=0.017). The volume of chest tube output increased the duration of mechanical ventilation (p=0.046) and the incidence of re-exploration after first 24 hours of observation (p=0.049). In patients with higher chest tube output, more packed red blood cells (PRBC), fresh frozen plasma (FFP), and platelet (PLT) transfusions were required (p=0.000, p=0.019, and p=0.000, respectively). Early rethoracotomy (within the first 24 hours post-surgery) increased the in-hospital mortality (p=0.021; OR 7.43 [1.36–40.64]). CONCLUSIONS: The study demonstrates the importance of postoperative bleeding and bleeding complications for short-term outcome in our post-HTX cohort. Throughout the analysis, the first postoperative hemoglobin level was detected to be a significant predictor of postoperative blood loss.pl
dc.affiliationWydział Lekarski : Instytut Kardiologiipl
dc.affiliationWydział Lekarski : Zakład Anestezjologii i Intensywnej Terapiipl
dc.affiliationWydział Lekarski : I Katedra Chirurgii Ogólnejpl
dc.cm.date2020-01-07
dc.cm.id79339
dc.contributor.authorKędziora, Anna - 175679 pl
dc.contributor.authorWierzbicki, Karol - 133767 pl
dc.contributor.authorMazur, Piotr - 139229 pl
dc.contributor.authorSong, Bryan HyoChanpl
dc.contributor.authorPiątek, Jacekpl
dc.contributor.authorMilaniak, Irenapl
dc.contributor.authorWęgrzyn, Piotrpl
dc.contributor.authorKapelak, Bogusław - 130001 pl
dc.contributor.authorDrwiła, Rafał - 129257 pl
dc.contributor.authorSobczyk, Dorota - 355946 pl
dc.contributor.authorGórkiewicz-Kot, Izabelapl
dc.contributor.authorBartuś, Krzysztof - 200764 pl
dc.contributor.authorNiekowal, Bogdan - 214262 pl
dc.contributor.authorSadowski, Jerzy - 133347 pl
dc.date.accessioned2020-01-17T09:10:28Z
dc.date.available2020-01-17T09:10:28Z
dc.date.issued2016pl
dc.date.openaccess0
dc.description.accesstimew momencie opublikowania
dc.description.number1pl
dc.description.physical689-694pl
dc.description.points20pl
dc.description.versionostateczna wersja wydawcy
dc.description.volume21pl
dc.identifier.doi10.12659/AOT.898988pl
dc.identifier.eissn2329-0358pl
dc.identifier.issn1425-9524pl
dc.identifier.projectROD UJ / OPpl
dc.identifier.urihttps://ruj.uj.edu.pl/xmlui/handle/item/138803
dc.languageengpl
dc.language.containerengpl
dc.rightsUdzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Bez utworów zależnych 4.0 Międzynarodowa*
dc.rights.licenceCC-BY-NC-ND
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/legalcode.pl*
dc.share.typeotwarte czasopismo
dc.subject.enchest tubespl
dc.subject.enerythrocyte transfusionpl
dc.subject.enheart transplantationpl
dc.subject.enpostoperative hemorrhagepl
dc.subject.entreatment outcomepl
dc.subtypeArticlepl
dc.titleImpact of postoperative bleeding on short-term outcome in patients after orthotopic heart transplantation : a retrospective cohort studypl
dc.title.journalAnnals of Transplantationpl
dc.typeJournalArticlepl
dspace.entity.typePublication
dc.abstract.enpl
BACKGROUND: Orthotopic heart transplantation (HTX) remains the ultimate treatment option in patients with end-stage heart failure, endorsed by the European Society of Cardiology guidelines. The aim of the study is a complex evaluation of the postoperative bleeding after HTX and its influence on short-term outcome. MATERIAL AND METHODS: A retrospective cohort study consisted of 53 patients (4 females and 49 males, median age 52.5 years, IQR 17 years) who underwent HTX in the Department of Cardiovascular Surgery and Transplantology of John Paul II Hospital in Krakow between 2007 and 2014. RESULTS: The median chest tube output within first 24 hours after the surgery was 695 (550–870) mL. Bleeding decreased throughout the observation (p=0.000). The first postoperative hemoglobin level was a significant predictor of excessive blood loss (p=0.017). The volume of chest tube output increased the duration of mechanical ventilation (p=0.046) and the incidence of re-exploration after first 24 hours of observation (p=0.049). In patients with higher chest tube output, more packed red blood cells (PRBC), fresh frozen plasma (FFP), and platelet (PLT) transfusions were required (p=0.000, p=0.019, and p=0.000, respectively). Early rethoracotomy (within the first 24 hours post-surgery) increased the in-hospital mortality (p=0.021; OR 7.43 [1.36–40.64]). CONCLUSIONS: The study demonstrates the importance of postoperative bleeding and bleeding complications for short-term outcome in our post-HTX cohort. Throughout the analysis, the first postoperative hemoglobin level was detected to be a significant predictor of postoperative blood loss.
dc.affiliationpl
Wydział Lekarski : Instytut Kardiologii
dc.affiliationpl
Wydział Lekarski : Zakład Anestezjologii i Intensywnej Terapii
dc.affiliationpl
Wydział Lekarski : I Katedra Chirurgii Ogólnej
dc.cm.date
2020-01-07
dc.cm.id
79339
dc.contributor.authorpl
Kędziora, Anna - 175679
dc.contributor.authorpl
Wierzbicki, Karol - 133767
dc.contributor.authorpl
Mazur, Piotr - 139229
dc.contributor.authorpl
Song, Bryan HyoChan
dc.contributor.authorpl
Piątek, Jacek
dc.contributor.authorpl
Milaniak, Irena
dc.contributor.authorpl
Węgrzyn, Piotr
dc.contributor.authorpl
Kapelak, Bogusław - 130001
dc.contributor.authorpl
Drwiła, Rafał - 129257
dc.contributor.authorpl
Sobczyk, Dorota - 355946
dc.contributor.authorpl
Górkiewicz-Kot, Izabela
dc.contributor.authorpl
Bartuś, Krzysztof - 200764
dc.contributor.authorpl
Niekowal, Bogdan - 214262
dc.contributor.authorpl
Sadowski, Jerzy - 133347
dc.date.accessioned
2020-01-17T09:10:28Z
dc.date.available
2020-01-17T09:10:28Z
dc.date.issuedpl
2016
dc.date.openaccess
0
dc.description.accesstime
w momencie opublikowania
dc.description.numberpl
1
dc.description.physicalpl
689-694
dc.description.pointspl
20
dc.description.version
ostateczna wersja wydawcy
dc.description.volumepl
21
dc.identifier.doipl
10.12659/AOT.898988
dc.identifier.eissnpl
2329-0358
dc.identifier.issnpl
1425-9524
dc.identifier.projectpl
ROD UJ / OP
dc.identifier.uri
https://ruj.uj.edu.pl/xmlui/handle/item/138803
dc.languagepl
eng
dc.language.containerpl
eng
dc.rights*
Udzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Bez utworów zależnych 4.0 Międzynarodowa
dc.rights.licence
CC-BY-NC-ND
dc.rights.uri*
http://creativecommons.org/licenses/by-nc-nd/4.0/legalcode.pl
dc.share.type
otwarte czasopismo
dc.subject.enpl
chest tubes
dc.subject.enpl
erythrocyte transfusion
dc.subject.enpl
heart transplantation
dc.subject.enpl
postoperative hemorrhage
dc.subject.enpl
treatment outcome
dc.subtypepl
Article
dc.titlepl
Impact of postoperative bleeding on short-term outcome in patients after orthotopic heart transplantation : a retrospective cohort study
dc.title.journalpl
Annals of Transplantation
dc.typepl
JournalArticle
dspace.entity.type
Publication
Affiliations

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