Cardiothoracic & vascular anesthesia
Coagulation Tests and Bleeding Classification After Cardiopulmonary Bypass: A Prospective Study
Authors' conclusion
Standard coagulation tests and individual components of TEG in isolation agree poorly with the visual classification of microvascular bleeding after CPB. The PT-INR and platelet count performed best but had low accuracy.
Study context
- Population
- Patients ≥18 years undergoing elective cardiac surgery with cardiopulmonary bypass (CPB), single-centre academic hospital358 bleeders · 458 nonbleeders
- Participants
- 816 patients
- Comparison
- Standard coagulation tests and TEG values vs visual (surgeon and anaesthesiologist consensus) classification of microvascular bleeding after CPB
- Outcome
- Classification of microvascular bleeding after CPB
Methodological detailssingle-centre
- Single-centre
Performance
As reported in the abstract
| Test or model | Sensitivity | Specificity | Accuracy |
|---|---|---|---|
| Prothrombin time (PT) | 51% | 70% | 62% |
| International normalized ratio (INR) | 48% | 72% | 62% |
| Platelet count | 62% | 61% | 62% |
Sensitivity
Prothrombin time (PT)51%
International normalized ratio (INR)48%
Platelet count62%
Specificity
Prothrombin time (PT)70%
International normalized ratio (INR)72%
Platelet count61%
Accuracy
Prothrombin time (PT)62%
International normalized ratio (INR)62%
Platelet count62%
- Accuracy, sensitivity and specificity of all coagulation profile tests and TEG values ranged
- 45% to 72%
Secondary outcomes
Chest tube drainage, total blood loss, RBC transfusion, reoperation (bleeders vs nonbleeders)
- Higher in bleeders vs nonbleeders
- P < 0.001, respectively
Readmission within 30 days (bleeders vs nonbleeders)
- Worse in bleeders vs nonbleeders
- P = 0.007
Hospital mortality (bleeders vs nonbleeders)
- Worse in bleeders vs nonbleeders
- P = 0.021
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Coagulation Tests and Bleeding Classification After Cardiopulmonary Bypass: A Prospective Study. J Cardiothorac Vasc Anesth. Published 6 February 2023. doi:10.
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