Abstract:
BACKGROUND:Surgical patients receive platelet concentrates (PCs) for a variety of indications. However, there is limited evidence for efficacy or dosing of PCs. STUDY DESIGN AND METHODS:We performed a retrospective cohort study of surgical patients receiving isolated PC transfusion at a single academic tertiary medical center during 1 year. The primary outcome was reoperation for a bleeding complication. Bleeding complication rates were compared in patients transfused for different indications, and multivariable logistic regression was performed to determine variables associated with bleeding complications. RESULTS:Approximately 1% of surgical patients (n = 205), including 7% of cardiac surgery patients, received an isolated PC transfusion. Cardiac surgery patients accounted for 47% of isolated PC transfusions, followed by neurosurgery (19%) and gastrointestinal surgery (13%). Most patients (81%) received a single apheresis unit of PC. Common indications were antiplatelet drugs (50%), thrombocytopenia (19%), congenital platelet disorders (2%), and both thrombocytopenia and antiplatelet drugs (12%). Bleeding complications occurred in 23% of patients, with the lowest bleeding complication rate observed in patients transfused for antiplatelet drugs (13%) and the highest rate in patients transfused for thrombocytopenia with or without antiplatelet drugs (40% and 38%, respectively). Bleeding complications were more common in noncardiac surgery but had no association with transfusion indication. CONCLUSION:Despite transfusion for conventionally accepted indications, patients who received an isolated PC transfusion experienced a high rate of bleeding complications, particularly noncardiac surgery patients. Further studies are needed to establish optimal dosing, timing, and indications for perioperative PC transfusion.
journal_name
Transfusionjournal_title
Transfusionauthors
Anders M,Rock P,Cartron A,Chow J,Henderson R,Martz D,Tanaka K,Mazzeffi Mdoi
10.1111/trf.15156subject
Has Abstractpub_date
2019-05-01 00:00:00pages
1661-1666issue
5eissn
0041-1132issn
1537-2995journal_volume
59pub_type
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