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U-shaped relationship between pre-operative plasma fibrinogen levels and severe peri-operative bleeding in cardiac surgery.

dc.rights.licenseopenen_US
hal.structure.identifierBiologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
dc.contributor.authorMION, Stefano
hal.structure.identifierBiologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
dc.contributor.authorDUVAL, Benoît
hal.structure.identifierBiologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
dc.contributor.authorBESNARD, Thibaut
dc.contributor.authorDARNÉ, Bernadette
dc.contributor.authorMOUTON, Christine
dc.contributor.authorJECKER, Olivier
dc.contributor.authorLABROUSSE, Louis
hal.structure.identifierBiologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
dc.contributor.authorREMY, Alain
dc.contributor.authorZAOUTER, Cédrick
hal.structure.identifierBiologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
dc.contributor.authorOUATTARA, Alexandre
dc.date.accessioned2022-04-22T07:20:46Z
dc.date.available2022-04-22T07:20:46Z
dc.date.issued2020-01-01
dc.identifier.issn1365-2346en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/139893
dc.description.abstractEnAn 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.isoENen_US
dc.subject.enCardiac Surgical Procedures
dc.subject.enFibrinogen
dc.subject.enHumans
dc.subject.enPlasma
dc.subject.enPostoperative Hemorrhage
dc.subject.enRetrospective Studies
dc.title.enU-shaped relationship between pre-operative plasma fibrinogen levels and severe peri-operative bleeding in cardiac surgery.
dc.title.alternativeEur J Anaesthesiolen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1097/EJA.0000000000001246en_US
dc.subject.halSciences du Vivant [q-bio]en_US
dc.identifier.pubmed32925436en_US
bordeaux.journalEuropean Journal of Anaesthesiologyen_US
bordeaux.page889-897en_US
bordeaux.volume37en_US
bordeaux.hal.laboratoriesBiologie des maladies cardiovasculaires (BMC) - UMR 1034en_US
bordeaux.issue10en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
bordeaux.import.sourcepubmed
hal.exportfalse
workflow.import.sourcepubmed
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_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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