The Effect of Aspirin on Bleeding and Transfusion in Contemporary Cardiac Surgery.

Authors

Jordan E Goldhammer, Department of Anesthesiology, Sidney Kimmel Medical College, Thomas Jefferson UniversityFollow
Gregary D. Marhefka, Division of Cardiology, Department of Medicine, Sidney Kimmel Medical College, Thomas Jefferson UniversityFollow
Constantine Daskalakis, Division of Biostatistics, Sidney Kimmel Medical College, Thomas Jefferson UniversityFollow
Mark W Berguson, Department of Anesthesiology, Sidney Kimmel Medical College, Thomas Jefferson UniversityFollow
John E Bowen, Sidney Kimmel Medical College, Thomas Jefferson University
James Diehl, Division of Cardiothoracic Surgery, Jefferson Medical College, Thomas Jefferson UniversityFollow
Jianzhong Sun, Department of Anesthesiology, Sidney Kimmel Medical College, Thomas Jefferson UniversityFollow

Document Type

Article

Publication Date

7-31-2015

Comments

This article has been peer reviewed. It was published in: PLoS ONE.

Volume 10, Issue 7, 31 July 2015, Article number e0134670.

The published version is available at DOI: 10.1371/journal.pone.0134670

Copyright © 2015 Goldhammer et al.

Abstract

OBJECTIVE: Despite evidence that preoperative aspirin improves outcomes in cardiac surgery, recommendations for aspirin use are inconsistent due to aspirin's anti-platelet effect and concern for bleeding. The purpose of this study was to investigate preoperative aspirin use and its effect on bleeding and transfusion in cardiac surgery.

METHODS: This retrospective study involved consecutive patients (n=1571) who underwent CABG, valve, or combined CABG and valve surgery at a single center between March 2007 and July 2012. Of all patients, 728 met the inclusion criteria and were divided into two groups: those using (n=603) or not using (n=125) aspirin within 5 days of surgery. Data were collected on chest tube drainage, re-operation for bleeding, and transfusion of red blood cells (RBCs), fresh frozen plasma (FFP), and platelets.

RESULTS: No significant difference was observed between the two groups in chest tube drainage or re-operation for bleeding. An increase in patients transfused with RBCs was observed in the aspirin group (61.9 vs 51.2%, adjusted OR 1.77, p=0.027); however, among those transfused RBCs, no significant difference in mean units transfused or massive transfusion was observed. No significant difference was seen in transfusion requirement of FFP or platelets.

CONCLUSIONS: In patients undergoing CABG, valve, or combined CABG/valve surgery, preoperative aspirin, within 5 days of surgery, was associated with an increased probability of receiving an RBC transfusion. Preoperative aspirin was not associated with an increase in chest tube drainage, re-operation for bleeding complications, or transfusion of FFP or platelets.

Recommended Citation

Goldhammer, Jordan E; Marhefka, Gregary D.; Daskalakis, Constantine; Berguson, Mark W; Bowen, John E; Diehl, James; and Sun, Jianzhong, "The Effect of Aspirin on Bleeding and Transfusion in Contemporary Cardiac Surgery." (2015). Department of Medicine Faculty Papers. Paper 129.
https://jdc.jefferson.edu/medfp/129

PubMed ID

26230605