January 1991

Preoperative Aspirin Therapy and Reoperation for Bleeding After Coronary Artery Bypass Surgery

Author Affiliations

From the Departments of Anesthesiology (Drs Bashein and Rice and Mr Nessly), Medicine (Dr Counts), and Surgery (Dr Misbach), University of Washington School of Medicine; and the Puget Sound Blood Center (Dr Counts), Seattle, Wash.

Arch Intern Med. 1991;151(1):89-93. doi:10.1001/archinte.1991.00400010105014

We performed a case-control study to estimate the relative risk of reoperation for bleeding in coronary artery bypass graft patients who had taken aspirin within the 7 days preceding sur gery. Comparison of 90 cases of reoperation with 180 matched control subjects gave an estimated odds ratio for reoperation of 1082 (95% confidence interval, 1.23 to 3.32). Although their preop erative coagulation values were similar, cases used significantly more whole blood (cases, 9.5 + 5.2 units; control subjects, 3.0 + 2.0 units; median + interquartile range), packed red blood cells (cases, 2.1 + 4.0 units; control subjects, 0.9 +- 2.0 units), and platelets (cases, 12.2 +- 12.0 units; control subjects, 2.9 +- 4.0 units) than control subjects. Cases had intensive care unit stays of 4.7 +- 5.7 days (mean SD) vs 2.1 1.9 days for control subjects and postoperative hospitalizations of 10.9 +- 8.2 days vs 7.0 +- 3.2 days for control subjects. We conclude that aspirin exposure within 7 days before coronary bypass surgery is asso ciated with an increased rate of reoperation for bleeding and that reoperation is associated with large increases in transfusion requirements and intensive care unit and hospital stays.

(Arch Intern Med. 1991;151:89-93)