FREQUENCY OF POST-CORONARY ARTERY BYPASS GRAFT (CABG) THROMBOCYTOPENIA AND ITS ASSOCIATED COMPLICATIONS
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Keywords
Thrombocytopenia, Coronary Artery Bypass Grafting, Cardiopulmonary Bypass, Platelet Count, Postoperative Complications
Abstract
Background: A frequent hematological side effect after coronary artery bypass grafting (CABG), especially in patients having cardiopulmonary bypass (CPB), is thrombocytopenia. Although its precise prognostic importance is still up for debate, severe thrombocytopenia may put patients at risk for complications like stroke, acute kidney damage (AKI), and bleeding. The purpose of this study was to ascertain the prevalence of thrombocytopenia following CABG and evaluate its correlation with significant postoperative complications in a Pakistani tertiary cardiac institution.
Methods: From June to December 2022, a descriptive case series was carried out at the Rehman Medical Institute in Peshawar. Non-probability consecutive sampling was used to enroll seventy-four adult patients undergoing urgent or elective isolated CABG. A platelet count <150×10⁹/L on any postoperative day was considered thrombocytopenia, which was further divided into three categories: mild (100–149×10⁹/L), moderate (50–99×10⁹/L), and severe (<50×10⁹/L). On the first, second, third, fourth, fifth, and ten postoperative days, platelet levels were tracked. Significant bleeding, AKI (according to KDIGO criteria), and stroke were among the complications noted. SPSS v25.0 was used to analyze the data, and p<0.05 was deemed significant.
Results: Patients were 56.7±5.9 years old on average, and 67.6% of them were men. 16.2% (n=12) of patients had thrombocytopenia, with mild cases accounting for 5.4%, moderate cases for 6.8%, and severe cases for 4.1%. AKI (1.4%), stroke (1.4%), and re-exploration for bleeding (4.1%) were among the complications. Neither complications nor demographic factors were found to be statistically associated with thrombocytopenia.
Conclusion: 16.2% of patients experienced post-CABG thrombocytopenia, with mild to moderate cases accounting for the majority of cases. Thrombocytopenia demonstrated a clinical trend toward more postoperative problems, although this trend was not statistically significant. For better risk stratification, routine postoperative platelet monitoring is advised, as are upcoming research projects that use dynamic platelet indices.
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Waleed Shahzad Ali
Rehman Medical Institute, And now SIUT Karachi
Muhammad Zaid Ali
Rehman Medical Institute and Now SIUT
Ahmad Mahmood
Rehman Medical Institute and Now PAF Hospital Islamabad
Salman Farsi
Rehman Medical Institute Now Bahria Orchard Hospital
Muhammad Wasim Sajjad
Registrar Cardiac Surgery, Sheikh Muhammad Bin Zayed Al Nahyan Inst of Cardiology Quetta
Dr Imran
Rehman Medical Institute