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Bleeding, transfusion and the risk of stroke after coronary surgery: A prospective cohort study of 2357 patients

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Bleeding, transfusion and the risk of stroke after coronary surgery: A prospective cohort study of 2357 patients. / Biancari, Fausto; Tauriainen, Tuomas; Perrotti, Andrea; Dalén, Magnus; Faggian, Giuseppe; Franzese, Ilaria; Chocron, Sidney; Ruggieri, Vito G; Bounader, Karl; Gulbins, Helmut; Reichart, Daniel; Svenarud, Peter; Santarpino, Giuseppe; Fischlein, Theodor; Puski, Tamas; Maselli, Daniele; Dominici, Carmelo; Nardella, Saverio; Mariscalco, Giovanni; Gherli, Riccardo; Musumeci, Francesco; Rubino, Antonino S; Mignosa, Carmelo; De Feo, Marisa; Bancone, Ciro; Gatti, Giuseppe; Maschietto, Luca; Santini, Francesco; Salsano, Antonio; Nicolini, Francesco; Gherli, Tiziano; Zanobini, Marco; Saccocci, Matteo; D'Errigo, Paola; Kinnunen, Eeva-Maija; Onorati, Francesco.

In: INT J SURG, Vol. 32, 08.2016, p. 50-57.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Biancari, F, Tauriainen, T, Perrotti, A, Dalén, M, Faggian, G, Franzese, I, Chocron, S, Ruggieri, VG, Bounader, K, Gulbins, H, Reichart, D, Svenarud, P, Santarpino, G, Fischlein, T, Puski, T, Maselli, D, Dominici, C, Nardella, S, Mariscalco, G, Gherli, R, Musumeci, F, Rubino, AS, Mignosa, C, De Feo, M, Bancone, C, Gatti, G, Maschietto, L, Santini, F, Salsano, A, Nicolini, F, Gherli, T, Zanobini, M, Saccocci, M, D'Errigo, P, Kinnunen, E-M & Onorati, F 2016, 'Bleeding, transfusion and the risk of stroke after coronary surgery: A prospective cohort study of 2357 patients', INT J SURG, vol. 32, pp. 50-57. https://doi.org/10.1016/j.ijsu.2016.06.032

APA

Biancari, F., Tauriainen, T., Perrotti, A., Dalén, M., Faggian, G., Franzese, I., Chocron, S., Ruggieri, V. G., Bounader, K., Gulbins, H., Reichart, D., Svenarud, P., Santarpino, G., Fischlein, T., Puski, T., Maselli, D., Dominici, C., Nardella, S., Mariscalco, G., ... Onorati, F. (2016). Bleeding, transfusion and the risk of stroke after coronary surgery: A prospective cohort study of 2357 patients. INT J SURG, 32, 50-57. https://doi.org/10.1016/j.ijsu.2016.06.032

Vancouver

Biancari F, Tauriainen T, Perrotti A, Dalén M, Faggian G, Franzese I et al. Bleeding, transfusion and the risk of stroke after coronary surgery: A prospective cohort study of 2357 patients. INT J SURG. 2016 Aug;32:50-57. https://doi.org/10.1016/j.ijsu.2016.06.032

Bibtex

@article{38f776d5892049a49d3a8bc78bcbfc23,
title = "Bleeding, transfusion and the risk of stroke after coronary surgery: A prospective cohort study of 2357 patients",
abstract = "INTRODUCTION: This study was planned to investigate the impact of severe bleeding and blood transfusion on the development of stroke after coronary surgery.METHODS: This cohort study includes 2357 patients undergoing isolated CABG from the prospective European Coronary Artery Bypass Grafting (E-CABG) registry. Severity of bleeding was categorized according to the Universal Definition of Perioperative Bleeding (UDPB), E-CABG and PLATO definitions.RESULTS: Thirty patients (1.3%) suffered postoperative stroke. The amount of transfused red blood cell (RBC) (OR 1.10, 95%CI 1.03-1.18), preoperative use of unfractioned heparin (OR 4.49, 95%CI 1.91-10.60), emergency operation (OR 3.97, 95%CI 1.47-10.74), diseased ascending aorta (OR 4.62, 95%CI 1.37-15.65) and use of cardiopulmonary bypass (p = 0.043, OR 4.85, 95%CI 1.05-22.36) were independent predictors of postoperative stroke. Adjusted analysis showed that UDPB classes 3-4 (crude rate: 3.6% vs. 1.0%; adjusted OR 2.66, 95%CI 1.05-6.73), E-CABG bleeding grades 2-3 (crudes rate: 6.3% vs. 0.9%; adjusted OR 5.91, 95%CI 2.43-14.36), and PLATO life-threatening bleeding (crude rate: 2.5% vs. 0.6%, adjusted OR 3.70, 95%CI 1.59-8.64) were associated with an increased risk of stroke compared with no or moderate bleeding.CONCLUSIONS: Bleeding and blood transfusion are associated with an increased risk of stroke after CABG, which is highest in patients with severe bleeding.",
keywords = "Aged, Cardiopulmonary Bypass/adverse effects, Coronary Artery Bypass/adverse effects, Female, Hemorrhage/complications, Heparin, Humans, Male, Middle Aged, Postoperative Hemorrhage/complications, Prospective Studies, Registries, Risk Factors, Stroke/etiology",
author = "Fausto Biancari and Tuomas Tauriainen and Andrea Perrotti and Magnus Dal{\'e}n and Giuseppe Faggian and Ilaria Franzese and Sidney Chocron and Ruggieri, {Vito G} and Karl Bounader and Helmut Gulbins and Daniel Reichart and Peter Svenarud and Giuseppe Santarpino and Theodor Fischlein and Tamas Puski and Daniele Maselli and Carmelo Dominici and Saverio Nardella and Giovanni Mariscalco and Riccardo Gherli and Francesco Musumeci and Rubino, {Antonino S} and Carmelo Mignosa and {De Feo}, Marisa and Ciro Bancone and Giuseppe Gatti and Luca Maschietto and Francesco Santini and Antonio Salsano and Francesco Nicolini and Tiziano Gherli and Marco Zanobini and Matteo Saccocci and Paola D'Errigo and Eeva-Maija Kinnunen and Francesco Onorati",
note = "Copyright {\textcopyright} 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.",
year = "2016",
month = aug,
doi = "10.1016/j.ijsu.2016.06.032",
language = "English",
volume = "32",
pages = "50--57",
journal = "INT J SURG",
issn = "1743-9191",
publisher = "Elsevier BV",

}

RIS

TY - JOUR

T1 - Bleeding, transfusion and the risk of stroke after coronary surgery: A prospective cohort study of 2357 patients

AU - Biancari, Fausto

AU - Tauriainen, Tuomas

AU - Perrotti, Andrea

AU - Dalén, Magnus

AU - Faggian, Giuseppe

AU - Franzese, Ilaria

AU - Chocron, Sidney

AU - Ruggieri, Vito G

AU - Bounader, Karl

AU - Gulbins, Helmut

AU - Reichart, Daniel

AU - Svenarud, Peter

AU - Santarpino, Giuseppe

AU - Fischlein, Theodor

AU - Puski, Tamas

AU - Maselli, Daniele

AU - Dominici, Carmelo

AU - Nardella, Saverio

AU - Mariscalco, Giovanni

AU - Gherli, Riccardo

AU - Musumeci, Francesco

AU - Rubino, Antonino S

AU - Mignosa, Carmelo

AU - De Feo, Marisa

AU - Bancone, Ciro

AU - Gatti, Giuseppe

AU - Maschietto, Luca

AU - Santini, Francesco

AU - Salsano, Antonio

AU - Nicolini, Francesco

AU - Gherli, Tiziano

AU - Zanobini, Marco

AU - Saccocci, Matteo

AU - D'Errigo, Paola

AU - Kinnunen, Eeva-Maija

AU - Onorati, Francesco

N1 - Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

PY - 2016/8

Y1 - 2016/8

N2 - INTRODUCTION: This study was planned to investigate the impact of severe bleeding and blood transfusion on the development of stroke after coronary surgery.METHODS: This cohort study includes 2357 patients undergoing isolated CABG from the prospective European Coronary Artery Bypass Grafting (E-CABG) registry. Severity of bleeding was categorized according to the Universal Definition of Perioperative Bleeding (UDPB), E-CABG and PLATO definitions.RESULTS: Thirty patients (1.3%) suffered postoperative stroke. The amount of transfused red blood cell (RBC) (OR 1.10, 95%CI 1.03-1.18), preoperative use of unfractioned heparin (OR 4.49, 95%CI 1.91-10.60), emergency operation (OR 3.97, 95%CI 1.47-10.74), diseased ascending aorta (OR 4.62, 95%CI 1.37-15.65) and use of cardiopulmonary bypass (p = 0.043, OR 4.85, 95%CI 1.05-22.36) were independent predictors of postoperative stroke. Adjusted analysis showed that UDPB classes 3-4 (crude rate: 3.6% vs. 1.0%; adjusted OR 2.66, 95%CI 1.05-6.73), E-CABG bleeding grades 2-3 (crudes rate: 6.3% vs. 0.9%; adjusted OR 5.91, 95%CI 2.43-14.36), and PLATO life-threatening bleeding (crude rate: 2.5% vs. 0.6%, adjusted OR 3.70, 95%CI 1.59-8.64) were associated with an increased risk of stroke compared with no or moderate bleeding.CONCLUSIONS: Bleeding and blood transfusion are associated with an increased risk of stroke after CABG, which is highest in patients with severe bleeding.

AB - INTRODUCTION: This study was planned to investigate the impact of severe bleeding and blood transfusion on the development of stroke after coronary surgery.METHODS: This cohort study includes 2357 patients undergoing isolated CABG from the prospective European Coronary Artery Bypass Grafting (E-CABG) registry. Severity of bleeding was categorized according to the Universal Definition of Perioperative Bleeding (UDPB), E-CABG and PLATO definitions.RESULTS: Thirty patients (1.3%) suffered postoperative stroke. The amount of transfused red blood cell (RBC) (OR 1.10, 95%CI 1.03-1.18), preoperative use of unfractioned heparin (OR 4.49, 95%CI 1.91-10.60), emergency operation (OR 3.97, 95%CI 1.47-10.74), diseased ascending aorta (OR 4.62, 95%CI 1.37-15.65) and use of cardiopulmonary bypass (p = 0.043, OR 4.85, 95%CI 1.05-22.36) were independent predictors of postoperative stroke. Adjusted analysis showed that UDPB classes 3-4 (crude rate: 3.6% vs. 1.0%; adjusted OR 2.66, 95%CI 1.05-6.73), E-CABG bleeding grades 2-3 (crudes rate: 6.3% vs. 0.9%; adjusted OR 5.91, 95%CI 2.43-14.36), and PLATO life-threatening bleeding (crude rate: 2.5% vs. 0.6%, adjusted OR 3.70, 95%CI 1.59-8.64) were associated with an increased risk of stroke compared with no or moderate bleeding.CONCLUSIONS: Bleeding and blood transfusion are associated with an increased risk of stroke after CABG, which is highest in patients with severe bleeding.

KW - Aged

KW - Cardiopulmonary Bypass/adverse effects

KW - Coronary Artery Bypass/adverse effects

KW - Female

KW - Hemorrhage/complications

KW - Heparin

KW - Humans

KW - Male

KW - Middle Aged

KW - Postoperative Hemorrhage/complications

KW - Prospective Studies

KW - Registries

KW - Risk Factors

KW - Stroke/etiology

U2 - 10.1016/j.ijsu.2016.06.032

DO - 10.1016/j.ijsu.2016.06.032

M3 - SCORING: Journal article

C2 - 27343820

VL - 32

SP - 50

EP - 57

JO - INT J SURG

JF - INT J SURG

SN - 1743-9191

ER -