U-shaped relationship between pre-operative plasma fibrinogen levels and severe peri-operative bleeding in cardiac surgery.
| dc.rights.license | open | en_US |
| hal.structure.identifier | Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases | |
| dc.contributor.author | MION, Stefano | |
| hal.structure.identifier | Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases | |
| dc.contributor.author | DUVAL, Benoît | |
| hal.structure.identifier | Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases | |
| dc.contributor.author | BESNARD, Thibaut | |
| dc.contributor.author | DARNÉ, Bernadette | |
| dc.contributor.author | MOUTON, Christine | |
| dc.contributor.author | JECKER, Olivier | |
| dc.contributor.author | LABROUSSE, Louis | |
| hal.structure.identifier | Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases | |
| dc.contributor.author | REMY, Alain | |
| dc.contributor.author | ZAOUTER, Cédrick | |
| hal.structure.identifier | Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases | |
| dc.contributor.author | OUATTARA, Alexandre | |
| dc.date.accessioned | 2022-04-22T07:20:46Z | |
| dc.date.available | 2022-04-22T07:20:46Z | |
| dc.date.issued | 2020-01-01 | |
| dc.identifier.issn | 1365-2346 | en_US |
| dc.identifier.uri | https://oskar-bordeaux.fr/handle/20.500.12278/139893 | |
| dc.description.abstractEn | An inverse linear relationship has been reported between pre-operative fibrinogen levels and postoperative blood loss in cardiac surgery. However, recently high pre-operative fibrinogen levels have also been reported to be associated with increased blood transfusion and re-operation. We tested the hypothesis that the relationship between pre-operative fibrinogen levels and severe peri-operative bleeding is not linear. A large-scale (n = 3883) single-centre retrospective study. A tertiary care teaching hospital. We analysed data from our institutional database which includes all patients above 18 years who underwent on-pump cardiac surgery through a sternotomy between September 2010 and May 2014. Peri-operative severe bleeding adapted from the Universal Definition of Peri-operative Bleeding, class 3 or 4. The relationship between pre-operative fibrinogen levels and peri-operative severe bleeding was analysed by binary logistic regression. A cubic B-spline transformation was used to estimate the relationship between pre-operative fibrinogen level associated with excessive peri-operative bleeding. Severe peri-operative bleeding was observed in 957 (24.6%) patients. An L-shaped relationship was observed between pre-operative fibrinogen levels and 24-h postoperative blood loss. The relationship between pre-operative fibrinogen levels and severe peri-operative bleeding (i.e. Universal Definition of Peri-operative Bleeding class 3 or 4) was U-shaped: the risk of severe peri-operative bleeding bottomed at 3.3 g l when the upward sloping curve started at 5.8 g l with a steeper increase above 8.2 g l. We reported a U-shaped relationship between severe peri-operative bleeding and pre-operative fibrinogen levels. While a low-level of fibrinogen appears to be associated with a high risk of bleeding, a high level does not necessarily protect the patient against such a risk and could even be a risk factor for peri-operative bleeding. | |
| dc.language.iso | EN | en_US |
| dc.subject.en | Cardiac Surgical Procedures | |
| dc.subject.en | Fibrinogen | |
| dc.subject.en | Humans | |
| dc.subject.en | Plasma | |
| dc.subject.en | Postoperative Hemorrhage | |
| dc.subject.en | Retrospective Studies | |
| dc.title.en | U-shaped relationship between pre-operative plasma fibrinogen levels and severe peri-operative bleeding in cardiac surgery. | |
| dc.title.alternative | Eur J Anaesthesiol | en_US |
| dc.type | Article de revue | en_US |
| dc.identifier.doi | 10.1097/EJA.0000000000001246 | en_US |
| dc.subject.hal | Sciences du Vivant [q-bio] | en_US |
| dc.identifier.pubmed | 32925436 | en_US |
| bordeaux.journal | European Journal of Anaesthesiology | en_US |
| bordeaux.page | 889-897 | en_US |
| bordeaux.volume | 37 | en_US |
| bordeaux.hal.laboratories | Biologie des maladies cardiovasculaires (BMC) - UMR 1034 | en_US |
| bordeaux.issue | 10 | en_US |
| bordeaux.institution | Université de Bordeaux | en_US |
| bordeaux.institution | INSERM | en_US |
| bordeaux.peerReviewed | oui | en_US |
| bordeaux.inpress | non | en_US |
| bordeaux.import.source | pubmed | |
| hal.export | false | |
| workflow.import.source | pubmed | |
| dc.rights.cc | Pas de Licence CC | en_US |
| bordeaux.COinS | ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=European%20Journal%20of%20Anaesthesiology&rft.date=2020-01-01&rft.volume=37&rft.issue=10&rft.spage=889-897&rft.epage=889-897&rft.eissn=1365-2346&rft.issn=1365-2346&rft.au=MION,%20Stefano&DUVAL,%20Beno%C3%AEt&BESNARD,%20Thibaut&DARN%C3%89,%20Bernadette&MOUTON,%20Christine&rft.genre=article |
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