Background
Methods
Patient characteristics
Prosthetic valve system and procedure
Tranexamic acid administration
Transfusion criteria
Data collection and statistical analysis
Results
Patients’ characteristics
Total | TXA-group | Non-TXA-group |
P
| |
---|---|---|---|---|
(n = 146) | (n = 54) | (n = 92) | ||
Female sex (n) %
| (90) 62 | (28) 51 | (62) 67 |
0.07
|
Age (years)
| 81.5 ± 6.6 | 81.4 ± 6.2 | 81.7 ± 6.8 |
0.12
|
BMI (kg/m
2
)
| 27.0 ± 4.4 | 27.2 ± 3.7 | 26.9 ± 4.4 |
0.821
|
Logistic ES (%)
| 28.7 ± 18.8 | 27.4 ± 19.5 | 29.3 ± 18.6 |
0.606
|
STS score (%)
| 12.1 ± 5.0 | 12.1 ± 5.2 | 12.1 ± 4.9 |
0.989
|
Ejection fraction (%)
| 54.7 ± 15.7 | 55.2 ± 17.1 | 55.5 ± 14.3 |
0.402
|
Diabetes mellitus, (n) %
| (49) 34 | (15) 28 | (45) 49 |
0.110
|
CAD (n) %
| (84) 59 | (32) 59 | (52) 56 |
0.540
|
COPD (n) %
| (42) 29 | (15) 28 | (27) 29 |
0.936
|
Previous heart surgery (n) %
| (36) 25 | (14) 26 | (22) 24 |
0.549
|
Aspirin (n) %
| (82) 56 | (25) 46 | (57) 62 |
0.213
|
Pre-op serum Crea (mg/dL)
| 1.2 ± 0.5 | 1.3 ± 0.5 | 1.1 ± 0.5 |
0.074
|
Platelet count (10
3
/mm
3
)
| 243.7 ± 43.5 | 238.4 ± 80.9 | 250.1 ± 56.6 |
0.336
|
Pre-op Hb (g/dL)
| 12.3 ± 1.6 | 12.5 ± 1.6 | 12.2 ± 1.6 |
0.398
|
Pre-op Hct (%)
| 37.0 ± 5.1 | 37.4 ± 4.6 | 37.1 ± 4.2 |
0.778
|
PTT
| 27.5 ± 7.4 | 27.5 ± 4.4 | 28.0 ± 8.2 |
0.296
|
Quick
| 96.4 ± 18.6 | 94.8 ± 20.1 | 97.6 ± 18.9 |
0.304
|
Total | TXA-group | Non-TXA-group |
p
| |
---|---|---|---|---|
(n = 146) | (n = 54) | (n = 92) | ||
Time of operation (min)
| 98.3 ± 27.9 | 99.2 ± 27.0 | 100.0 ± 29.0 | 0.354 |
Rethoracotomy (n) %
| (11) 7 | (2) 4 | (9) 10 | 0.221 |
Serum Crea 72 h after TA-AVI (mg/dL)
| 1.5 ± 0.8 | 1.4 ± 0.8 | 1.4 ± 0.8 | 0.436 |
Need for haemodialysis (n) %
| (15) 10 | (5) 9 | (10) 11 | 0.751 |
Major neurologic deficit (n) %
| (3) | (1) 2 | (2) 2 | 0.946 |
Major thrombembolic complication (n) %*
| (2) 1 | (1) 2 | (1) 1 | 0.662 |
ICU stay (day)
| 4.2 ± 3.0 | 4.3 ± 3.2 | 4.2 ± 3.0 | 0.909 |
Hospital stay (day)
| 11.8 ± 5.8 | 10.8 ± 4.4 | 11.9 ± 5.6 | 0.586 |
30-day mortality (n) %
| (17) 11 | (6) 11 | (11) 12 | 0.988 |
Bleeding complications
Total | TXA-group | Non-TXA-group |
P
| |
---|---|---|---|---|
(n = 146) | (n = 54) | (n = 92) | ||
Blood loss 24 h after TA-AVI (mL)
| 425 ± 310 | 327 ± 274 | 481.1 ± 318.8 | 0.003 |
Blood loss 48 h after TA-AVI (mL)
| 214 ± 217 | 175 ± 152 | 219.1 ± 197.9 | 0.727 |
Number of RBC transfused patients (n/%)
| 54/68.7 | 13/24.1 | 41/44.6 | 0.013 |
Total units in hospital (units)
| 2.5 ± 3.1 | 2.1 ± 1.9 | 2.9 ± 3.5 | 0.046 |
Predictors of bleeding (Univariate Analysis)
Beta | Standard error |
p
| |
---|---|---|---|
Tranexam acid
| - 153.990 | 50.009 | 0.002 |
OR duration
| 0.545 | 0.908 | 0.550 |
ASS preoperative
| 58.656 | 50.872 | 0.251 |
INR preoperative
| 1.199 | 0.985 - 1.269 | 0.601 |
Beta | Standard error |
p
| |
---|---|---|---|
Tranexam acid
| - 1.161 | 0.518 | 0.026 |
ASS preoperative
| - 0.474 | 0.521 | 0.365 |
Hb preoperative
| - 0.432 | 0.164 | 0.009 |
Odds ratio | 95% Confidence interval |
p
| |
---|---|---|---|
EuroSCORE log
| 1.028 | 1.002 – 1.053 | 0.033 |
STS Score (ROM)
| 1.029 | 0.987 – 1.073 | 0.176 |
EF preoperatively
| 1.023 | 0.988 – 1.058 | 0.196 |
female gender
| 2.266 | 0.700 – 7.334 | 0.172 |
tranexam acid
| 0.920 | 0.320 – 2.648 | 0.878 |
Blood loss (POD 1) (ml)
| 1.002 | 1.000 – 1.003 | 0.036 |
Red blood cell transfusion
| 1.360 | 1.161 – 1.594 | <0.001 |
rethoracotomy
| 8.542 | 2.267 – 32.187 | 0.002 |