TABLE 5.
Risk Factors for Hemorrhage in Cardiac Surgical Patients
| Characteristics | Unadjusted | Adjusted | ||||
|---|---|---|---|---|---|---|
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| OR | 95% CI | pa | OR | 95% CI | pb | |
| Male sex | 1.02 | 0.89–1.16 | 0.83 | |||
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| Race | ||||||
| Caucasian | Ref | Ref | ||||
| African American | 1.00 | 0.8–1.23 | 0.07 | 1.03 | 0.81–1.30 | 0.27 |
| Asian | 0.75 | 0.58–0.97 | 0.76 | 0.56–1.03 | ||
| Hispanic | 0.83 | 0.68–1.00 | 0.91 | 0.73–1.12 | ||
| Other | 1.09 | 0.82–1.47 | 1.16 | 0.84–1.60 | ||
|
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| Age group | ||||||
| Neonate (0–28 d) | Ref | Ref | ||||
| Infant (29–365 d) | 1.01 | 0.87–1.18 | 0.04 | 1.04 | 0.87–1.25 | 0.002 |
| Child (366 d to 18 yr) | 1.27 | 1.05–1.54 | 1.51 | 1.19–1.92 | ||
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| Cardiac diagnosis | ||||||
| CHD | 0.98 | 0.65–1.47 | 0.93 | |||
| Non-CHD | Ref | |||||
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| Genetic anomaly | 0.95 | 0.73–1.23 | 0.68 | |||
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| Pre-ECMO | ||||||
| Pre-ECMO support | ||||||
| Pressor support | 0.83 | 0.68–1.00 | 0.05 | 0.96 | 0.76–1.20 | 0.71 |
| Cardiac mechanical support | 0.79 | 0.48–1.31 | 0.36 | |||
| Pulmonary vasodilatory support | 1.05 | 0.91–1.22 | 0.48 | |||
| Systemic afterload reduction | 0.96 | 0.84–1.10 | 0.57 | |||
| Steroids | 0.76 | 0.52–1.11 | 0.15 | |||
| Bicarbonate | 1.10 | 0.94–1.28 | 0.24 | |||
|
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| Pre-ECMO re-exploration for bleeding/mediastinal exploration | 3.92 | 2.41–6.73 | < 0.0001 | 3.61 | 2.07–6.27 | < 0.0001 |
|
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| On ECMO | ||||||
| Duration of ECMO, hr | < 0.0001 | < 0.0001 | ||||
| < 104 (< 50th percentile) | Ref | Ref | ||||
| 104–167 (50th to 75th percentile) | 1.39 | 1.18–1.63 | 1.38 | 1.15–1.65 | ||
| ≥167 (> 75th percentile) | 2.45 | 2.06–2.91 | 2.48 | 2.04–3.01 | ||
| ECMO mode | 0.047 | 0.24 | ||||
| Venoarterial | 0.51 | 0.25–0.98 | 0.63 | 0.29–1.37 | ||
| Venovenous or other | Ref | Ref | ||||
| Cannulation site | 0.04 | 0.74 | ||||
| Chest | 1.27 | 1.03–1.56 | 1.07 | 0.84–1.37 | ||
| Neck | Ref | Ref | ||||
| Groin or other | 0.84 | 0.45–1.57 | 0.87 | 0.42–1.81 | ||
|
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| Procedural | ||||||
| Society of Thoracic Surgeons morbidity category | 0.14 | 0.02 | ||||
| 1 to 3 | Ref | Ref | ||||
| 4 or 5 | 1.11 | 0.97–1.27 | 1.23 | 1.03–1.46 | ||
| Time from surgery to ECMO cannulation, hr | < 0.0001 | < 0.0001 | ||||
| ≤ 23 (≤ 75th percentile) | 1.49 | 1.27–1.73 | 1.58 | 1.31–1.90 | ||
| > 23 (> 75th percentile) | Ref | Ref | ||||
| Aortic surgery | 1.12 | 0.98–1.29 | 0.09 | 0.94 | 0.80–1.11 | 0.49 |
| Cardiopulmonary bypass time, min | < 0.0001 | < 0.0001 | ||||
| < 193 (< 50th percentile) | Ref | Ref | ||||
| 193–282 (50th to 75th percentile) | 1.32 | 1.11–1.56 | 1.18 | 0.98–1.42 | ||
| ≥ 282 (> 75th percentile) | 1.82 | 1.52–2.17 | 1.55 | 1.27–1.88 | ||
OR = odds ratio, Ref = reference category, CHD = congenital heart disease, ECMO = extracorporeal membrane oxygenation.
a
p value from univariate logistic regression.
b
p value from multivariable logistic regression.