Author + information
- Ahmed Farawi,
- Paula D. Strassle,
- Rahul Jaswaney,
- Christopher End,
- George Stouffer,
- Prashant Kaul and
- John Vavalle
Background: A peri-procedural hemoglobin (Hgb) drop of ≥ 3 g/dL without clinical bleeding qualifies as a major bleeding event according to the National Cardiovascular Data Registry (NCDR). However, risk factors, clinical outcomes and procedural differences in patients with Hgb drops have not been compared to patients experiencing clinically overt bleeding.
Methods: Multivariable logistic and linear regression was used to compare 52 patients who experienced a clinically silent peri-procedural Hgb drop to 44 patients who experienced overt bleeding following percutaneous coronary intervention (PCI) at the UNC Cardiac Cath Lab.
Results: Patients with Hgb drops were more likely to be younger and less likely to have chronic kidney disease (CKD). There were no significant differences in inpatient mortality or length of stay (Table 1). Patients with Hgb drops were less likely to receive blood transfusions or experience cardiogenic shock. Procedurally, there were no significant differences in copilot use, sheath size, procedure duration, closure method or procedural IV fluid intake.
Discussion: Patients with peri-procedural Hgb drops had similar inpatient outcomes to those with overt bleeding. There were no procedural differences to explain the Hgb drops, making hemodilution or procedural blood loss an unlikely cause. More research is warranted to identify the significance of peri-procedural Hgb drops, and to examine whether the 3 g/dL delineation established by the NCDR is justified.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Complexity and Complications
Abstract Category: 26. Interventional Cardiology: Vascular Access and Complications
Presentation Number: 1285-173
- 2017 American College of Cardiology Foundation