Cardiothoracic & vascular anesthesia
Factor Eight Inhibitor Bypass Activity Use in Cardiac Surgery: A Propensity-matched Analysis of Safety Outcomes
Authors' conclusion
Low-dose FEIBA administration during cardiac surgery does not increase risk of thromboembolic events, intensive care unit length of stay, or mortality in a propensity-matched cohort. Higher doses were associated with increased acute renal failure and postoperative transfusion.
Study context
- Population
- Adults undergoing cardiac surgery on CPB, Stanford Hospital, July 1, 2018–June 30, 20233,335 reviewed
- Participants
- 704 adults
- Exposure
- Factor eight inhibitor bypass activity (FEIBA) vs no FEIBA for post-CPB bleeding
- FEIBAn = 352
- No FEIBAn = 352reference
- Outcome
- Composite of thromboembolic complications (DVT, PE, unplanned coronary artery intervention, ischemic stroke, acute limb ischemia)
- Follow-up
- Postoperative period
Methodological detailspropensity-score matched (1:1, nearest neighbor), single-centre, Mean FEIBA dose 7.3 ± 5.5 U/kg
- Propensity-score matched (1:1, nearest neighbor)
- Single-centre
- Mean FEIBA dose 7.3 ± 5.5 U/kg
Main finding
As reported in the abstract
Thromboembolic outcomes
- No statistically significant difference in OR for thromboembolic outcomes
- Propensity-matched cohort
Observational data: associations, not effects.
Secondary outcomes
Acute renal failure, FEIBA >750 U (dose subgroup)
| OR (95% CI) | P value | ||
|---|---|---|---|
| FEIBA >750 UPropensity-matched multivariate logistic regression | 4.14 (1.61–10.36) | P < 0.001 | |
| 0.050.21520Odds ratio (log scale) |
Postoperative transfusion of erythrocytes and platelets, FEIBA 501 to 750 U (dose subgroup)
β
- Only the dose range of 501 to 750 U associated with increased erythrocyte transfusion
- 2.73 (95% CI 0.68 to 4.78, P = 0.009)
- Only the dose range of 501 to 750 U associated with increased platelet transfusion
- 1.74 (95% CI 0.85 to 2.63, P < 0.001)
- Multivariate linear regression
Postoperative plasma and cryoprecipitate transfusion
- Patients receiving FEIBA transfused more plasma and cryoprecipitate postoperatively
- Multivariate linear regression
ICU LOS and mortality
- No statistically significant difference in ORs
- Propensity-matched
Safety
Acute renal failure (FEIBA >750 U)
| OR (95% CI) | P value | ||
|---|---|---|---|
| FEIBA >750 U | 4.14 (1.61–10.36) | P < 0.001 | |
| 0.050.21520Odds ratio (log scale) |
Original publication
Factor Eight Inhibitor Bypass Activity Use in Cardiac Surgery: A Propensity-matched Analysis of Safety Outcomes. Anesthesiology. Published 26 August 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →