Clinical analysis of thrombocytopenia after cardiac surgery

Niu Xinrong; Li Na

doi:10.3760/cma.j.issn.1673-4777.2015.09.005

Abstract：Objective To investigate the clinical significance and risk factors of thrombocytopenia after cardiac surgery.Methods Totally 40 patients with thrombocytopenia after cardiac surgery from June 2011 to June 2014 were enrolled and divided into death group (10 cases) and survival group (30 cases) according to the treatment outcome.The chronic health evaluation,acute physiology (APACHE Ⅱ) score and blood test results 1,3,7,9 days after treatment were assessed ; the intraoperative hemorrhage,length of cardiopulmonary bypass time and postoperative intervention and infection (including lung,blood and incision infection) were recorded.The risk factors of thrombocytopenia and the correlation of thrombocytopenia and death after operation were analyzed.Results Seven and 9 days after treatment,the platelet count in death group was progressively decreased,significantly lower than that in survival group [(74 ±30) × 109/L vs (182 ±51) × 109/L,(46 ±33) × 109/L vs (195 ± 42) × 109/L] (all P ＜ 0.05).The APACHE Ⅱ scores 3,7,9 days after treatment were statistically lower in death group compared with those in survival group [(12 ± 4) scores vs (18 ± 3) scores,(9 ± 3) scores vs (21 ± 4) scores,(8 ± 2) scores vs (23 ± 2) scores] (all P ＜ 0.05).Multiple Logistic regression analysis showed that great intraoperative bleeding (x2 =6.554,P =0.005,OR =0.921,95％ CI:0.798-1.212),long extracorporeal circulation time (x2 =14.666,P =0.008,OR =0.977,95％ CI:0.921-1.301) and serious postoperative infection (x2 =7.337,P =0.007,OR =0.943,95％ CI:0.813-1.246) were correlated with thrombocytopenia; thrombocytopenia was correlated with postoperative death (x2 =4.603,P =0.032,OR =0.178,95％ CI:0.156-0.215).Conclusion The reduction of platelet count is related to the severity and prognosis of critical illness; greater intraoperative bleeding,longer extracorporeal circulation time,longer cardiopulmonary bypass time and serious infection are correlated with thrombocytopenia ; thrombocytopenia is a risk factor of postoperative more motality.