Preoperative Aspirin Therapy and Reoperation for Bleeding After Coronary Artery Bypass Surgery

doi:10.1001/archinte.1991.00400010105014

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Vol. 151 No. 1, JANUARY 1991

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Preoperative Aspirin Therapy and Reoperation for Bleeding After Coronary Artery Bypass Surgery

G. Bashein, MD, PhD; Michael L. Nessly; Andrew L. Rice, MD; Richard B. Counts, MD; Gregory A. Misbach, MD

Arch Intern Med. 1991;151(1):89-93.

Abstract

We performed a case-control study to estimate the relative riskof reoperation for bleeding in coronary artery bypass graftpatients who had taken aspirin within the 7 days preceding surgery. Comparison of 90 cases of reoperation with 180 matchedcontrol subjects gave an estimated odds ratio for reoperationof 1082 (95% confidence interval, 1.23 to 3.32). Although theirpreop erative coagulation values were similar, cases used significantlymore whole blood (cases, 9.5 + 5.2 units; control subjects,3.0 + 2.0 units; median + interquartile range), packed red bloodcells (cases, 2.1 + 4.0 units; control subjects, 0.9 +- 2.0units), and platelets (cases, 12.2 +- 12.0 units; control subjects,2.9 +- 4.0 units) than control subjects. Cases had intensivecare unit stays of 4.7 +- 5.7 days (mean SD) vs 2.1 1.9 daysfor control subjects and postoperative hospitalizations of 10.9+- 8.2 days vs 7.0 +- 3.2 days for control subjects. We concludethat aspirin exposure within 7 days before coronary bypass surgeryis asso ciated with an increased rate of reoperation for bleedingand that reoperation is associated with large increases in transfusionrequirements and intensive care unit and hospital stays.

(Arch Intern Med. 1991;151:89-93)

Author Affiliations

From the Departments of Anesthesiology (Drs Bashein and Rice and Mr Nessly), Medicine (Dr Counts), and Surgery (Dr Misbach), University of Washington School of Medicine; and the Puget Sound Blood Center (Dr Counts), Seattle, Wash.

Footnotes

Accepted for publication August 7, 1990.

Presented in part at the 11th Annual Meeting of the Societyof Cardiovascular Anesthesiologists, Seattle, Wash, April 1989,and at the Annual Meeting of the American Society of Anesthesiologists,New Orleans, La, October 1989.

Reprint requests to the Department of Anesthesiology, RN-10,University of Washington, Seattle, WA 98195 (Dr Bashein).N

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