Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/34971
Title: Platelet versus fresh frozen plasma transfusion for coagulopathy in cardiac surgery patients.
Austin Authors: Hinton, Jake V;Fletcher, Calvin M;Perry, Luke A;Greifer, Noah;Hinton, Jessica N;Williams-Spence, Jenni;Segal, Reny;Smith, Julian A;Reid, Christopher M;Weinberg, Laurence ;Bellomo, Rinaldo 
Affiliation: Anaesthesia
Department of Anaesthesiology and Perioperative Medicine, The Alfred Hospital, Melbourne, Australia.
Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Parkville, Australia.;Department of Critical Care, University of Melbourne, Parkville, Australia.
Harvard University Institute for Quantitative Social Science, Cambridge, MA, United States of America.
Department of Orthopaedics, Northern Health, Epping, Australia.
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Parkville, Australia.;Department of Critical Care, University of Melbourne, Parkville, Australia.
Department of Surgery (School of Clinical Sciences at Monash Health), Monash University, Melbourne, Australia.;Department of Cardiothoracic Surgery, Monash Health, Clayton, Australia.
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.;School of Public Health, Curtin University, Perth, WA, Australia.
Department of Critical Care, University of Melbourne, Parkville, Australia.
Department of Critical Care, University of Melbourne, Parkville, Australia.;Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Australia.;Department of Intensive Care, Austin Hospital, Melbourne, Victoria, Australia.;Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia.
Issue Date: 2024
Date: 2024
Publication information: PloS One 2024; 19(1)
Abstract: Platelets (PLTS) and fresh frozen plasma (FFP) are often transfused in cardiac surgery patients for perioperative bleeding. Their relative effectiveness is unknown. We conducted an entropy-weighted retrospective cohort study using the Australian and New Zealand Society of Cardiac and Thoracic Surgeons National Cardiac Surgery Database. All adults undergoing cardiac surgery between 2005-2021 across 58 sites were included. The primary outcome was operative mortality. Of 174,796 eligible patients, 15,360 (8.79%) received PLTS in the absence of FFP and 6,189 (3.54%) patients received FFP in the absence of PLTS. The median cumulative dose was 1 unit of pooled platelets (IQR 1 to 3) and 2 units of FFP (IQR 0 to 4) respectively. After entropy weighting to achieve balanced cohorts, FFP was associated with increased perioperative (Risk Ratio [RR], 1.63; 95% Confidence Interval [CI], 1.40 to 1.91; P<0.001) and 1-year (RR, 1.50; 95% CI, 1.32 to 1.71; P<0.001) mortality. FFP was associated with increased rates of 4-hour chest drain tube output (Adjusted mean difference in ml, 28.37; 95% CI, 19.35 to 37.38; P<0.001), AKI (RR, 1.13; 95% CI, 1.01 to 1.27; P = 0.033) and readmission to ICU (RR, 1.24; 95% CI, 1.09 to 1.42; P = 0.001). In perioperative bleeding in cardiac surgery patient, platelets are associated with a relative mortality benefit over FFP. This information can be used by clinicians in their choice of procoagulant therapy in this setting.
URI: https://ahro.austin.org.au/austinjspui/handle/1/34971
DOI: 10.1371/journal.pone.0296726
ORCID: 0000-0001-7764-0741
0000-0001-7582-9145
0000-0003-3067-7154
0000-0001-5805-5491
0000-0001-9173-3944
0000-0001-7403-7680
Journal: PloS One
Start page: e0296726
PubMed URL: 38232077
ISSN: 1932-6203
Type: Journal Article
Subjects: Cardiac Surgical Procedures/adverse effects
Platelet Transfusion/adverse effects
Appears in Collections:Journal articles

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