Abstract 3116: Preop Platelet Count <150K or >300K Increases Risk of Mortality, Renal Failure, Stroke and Reexploration Following CABG
Prediction of morbidity from preop data is important for individualizing therapy in CABG patients. We tested the hypothesis that preoperative platelet counts (PrePC) adds predictive value to STS Risk Algorithm (v2001.4) for mortality (M), stroke (S), re-exploration(ReX), and renal failure(RF) after primary and reop isolated CABG .
Methods: STS data elements and Clinical Lab data from 2915 consecutive patients (Center1=1603, Center2=1312) who underwent CABG (1/02–7/04) were used in multivariable models of surgical outcomes (SAS v8, p<0.05). For each outcome, after risk adjustment (STS v2001.4), significant variables indicating extremes of plt count were included in the model.
Results: PrePC over 300K or under 150K occured 23% in of patients. Table 1⇓ demonstrates odds ratios quantifying the effects of preoperative PrePC on risk of M, RF, Stroke, and ReX. Figure 1⇓ shows probability of death as a function of PrePC (mean +- 95% confidence limits). Note that risk increases with both increasing (>300) and decreasing (<150) PrePC.
Conclusion: Preoperative platelet count significantly impacts CABG outcome. The STS model underestimated risk when PrePC<150K or more than 300K. Mechanisms for this increased risk, and interventions to ameliorate it should be studied.