Document Detail


Lowest hematocrit on bypass and adverse outcomes associated with coronary artery bypass grafting. Northern New England Cardiovascular Disease Study Group.
MedLine Citation:
PMID:  11269449     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cardiac surgery patients' hematocrits frequently fall to low levels during cardiopulmonary bypass. METHODS: We investigated the association between nadir hematocrit and in-hospital mortality and other adverse outcomes in a consecutive series of 6,980 patients undergoing isolated coronary artery bypass graft surgery. The lowest hematocrit during cardiopulmonary bypass was recorded for each patient. Patients were divided into categories based on their lowest hematocrit. Women had a lower hematocrit during bypass than men but both sexes are represented in each category. RESULTS: After adjustment for preoperative differences in patient and disease characteristics, the lowest hematocrit during cardiopulmonary bypass was significantly associated with increased risk of in-hospital mortality, intra- or postoperative placement of an intraaortic balloon pump and return to cardiopulmonary bypass after attempted separation. Smaller patients and those with a lower preoperative hematocrit are at higher risk of having a low hematocrit during cardiopulmonary bypass. CONCLUSIONS: Female patients and patients with smaller body surface area may be more hemodiluted than larger patients. Minimizing intraoperative anemia may result in improved outcomes for this subgroup of patients.
Authors:
G R DeFoe; C S Ross; E M Olmstead; S D Surgenor; M P Fillinger; R C Groom; R J Forest; J W Pieroni; C S Warren; M E Bogosian; C F Krumholz; C Clark; R A Clough; P W Weldner; S J Lahey; B J Leavitt; C A Marrin; D C Charlesworth; P Marshall; G T O'Connor
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  71     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-03-27     Completed Date:  2001-05-31     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  769-76     Citation Subset:  AIM; IM    
Affiliation:
Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA. gordon.defoe@hitchcock.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Artery Bypass*
Female
Hematocrit
Hemodilution / adverse effects*
Humans
Male
Middle Aged
Postoperative Complications / etiology*,  mortality*
Prospective Studies
Treatment Outcome
Comments/Corrections
Comment In:
Ann Thorac Surg. 2002 Jul;74(1):296-7; author reply 297   [PMID:  12118794 ]
Ann Thorac Surg. 2001 Mar;71(3):765   [PMID:  11269447 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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