Exploring factors associated with bleeding events after open heart surgery in patients on dialysis − effects of the presence or absence of warfarin therapy

TL;DR

This study explores how low body weight and warfarin therapy affect bleeding after heart surgery in dialysis patients.

Contribution

The study identifies low body weight as a novel risk factor for postoperative bleeding in dialysis patients.

Findings

Low body weight was significantly associated with postoperative bleeding events (p = 0.038).

Warfarin therapy had no significant effect on bleeding, mortality, or stroke after surgery.

Further research is needed to explore additional risk factors with more cases.

Abstract

Perioperative management of patients on dialysis is critical for controlling bleeding and thrombotic risk, in addition to infection control. Postoperative anticoagulation is often difficult to control, and different institutions have different policies. Therefore, in this study, we aimed to investigate factors associated with postoperative bleeding events and whether warfarin (WF) therapy affects the incidence of postoperative bleeding events, total mortality, and stroke.

Patients who were admitted to the cardiovascular surgery department and underwent valve replacement or plasty were included, and those who underwent mechanical valve introduction were excluded. Thirty-nine patients were included in the study. The primary endpoint was to identify factors associated with the composite endpoint of postoperative bleeding events, and the secondary endpoint was to determine the effect size of WF therapy on postoperative bleeding events, all-cause mortality, and stroke and the strength of association between the crossed endpoints. The strength of the association between the crossed items was examined.

Low body weight (p = 0.038) was identified as a factor associated with the primary endpoint of postoperative bleeding events. The secondary endpoint of whether or not patients received WF therapy was largely unrelated to bleeding events, all-cause mortality, and postoperative stroke up to 90 days after surgery.

Preliminary studies suggest that low body weight is a risk factor for postoperative bleeding events in patients on dialysis, although further exploration of other factors will be necessary with the accumulation of similar cases.