10.25384/SAGE.C.6305173.V1
Mingke Li
Mingke
Li
Yawei Dai
Yawei
Dai
Shuai Hu
Shuai
Hu
Yansong Li
Yansong
Li
United States Army Institute of Surgical Research
Jilin University
Dasheng Lu
Dasheng
Lu
Rui Zheng
Rui
Zheng
China West Normal University
Tianjin Normal University
First Affiliated Hospital of Wenzhou Medical University
Nanjing Medical University
Kai Wang
Kai
Wang
Peking University
Xinjiang Medical University
University of Iowa
Children's Hospital of Philadelphia
Tongji University
China Pharmaceutical University
Fu Jen Catholic University
Fujian Agriculture and Forestry University
Jinan University
University of Pennsylvania
Nantong University
Shandong University
Kunming Medical University
Huazhong University of Science and Technology
Huazhong Agricultural University
Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital
Shanghai Ocean University
Shanghai International Studies University
Shenyang Agricultural University
Jiangsu Province Hospital
First Affiliated Hospital of Anhui Medical University
Cathay General Hospital
Ministry of Agriculture and Rural Affairs
Bristol-Myers Squibb (United States)
Tufts University
Beijing University of Chemical Technology
Wuhan University
Sichuan Agricultural University
Fudan University
Nanjing Medical University
The association between preoperative blood calcium and postoperative blood loss in patients undergoing heart valve replacement surgery
<div>Introduction<p>Bleeding after heart valve surgery is a serious clinical challenge. Hypocalcemia has been associated with the extent of bleeding in patients with spontaneous intracerebral hemorrhage. However, the association between blood calcium levels and bleeding extent in heart valve replacement patients has not been clearly established. This study aimed at determining the association between blood calcium levels and perioperative hemorrhage after heart valve replacement therapy.</p>Methods<p>Based on preoperative blood calcium levels, patients were grouped into the hypocalcemia group and normocalcemia group. Postoperative bleeding, blood product use, and complications were monitored during hospitalization. The association between blood calcium levels and major bleeding was determined by multivariable logistic regression models.</p>Results<p>In the first 12 h after surgery, bleeding in hypocalcemia group was significantly larger than that of the normocalcemia group (338 ± 234 mL vs 232 ± 96 mL; <i>p</i> = .024). The outcome was the same when the overall chest tube output was considered (950 ± 447 mL vs 738 ± 220 mL; <i>p</i> = .038). The incidence of major bleeding was 65.91% in the hypocalcemia group and 18.97% in the normocalcemia group (<i>p</i> = .001). Postoperative complications in the two groups were similar. After adjusting for multiple covariates, the adjusted odds ratios (OR) for participants in hypocalcemia group was 10.01 (95% CI 3.35–34.82), compared with that in normocalcemia group (<i>p</i> < .001).</p>Conclusion<p>In patients undergoing heart valve surgery, preoperative blood concentrations of calcium are associated with postoperative blood loss. Hypocalcemia before operation may increase the risk of postoperative bleeding. When patients with valvular heart disease present with hypocalcemia before surgery, prompt intervention may lead to better control of postoperative bleeding.</p></div>
Cardiology
110323 Surgery
SAGE Journals
2022
2022-11-18
2022-11-18
Collection
10.1177/02676591221140239
10.25384/SAGE.c.6305173
CC BY 4.0