Thrombocytopenia After Cardiac Surgery: A Single-Center Retrospective Study
Abstract
BACKGROUND: Postoperative thrombocytopenia is a frequent complication in cardiac surgery, associated with increased morbidity and mortality. Our study aimed to describe platelet count after cardiac surgery and identify predictors of postoperative thrombocytopenia. METHODS: We conducted a retrospective, single-center study including 519 adult patients who underwent cardiac surgery without operative platelet transfusion. The primary outcome was the incidence of postoperative thrombocytopenia, defined using three thresholds: <150 G/L, <100 G/L, and <50 G/L. Platelet counts were recorded daily from preoperative day to postoperative day 7. Independent predictors were identified using multivariate logistic regression for a threshold of 100 G/L. RESULTS: Thrombocytopenia < 150 G/L occurred in 306 patients (59%), <100 G/L in 92 (18%), and < 50 G/L in 35 (7%). The incidence of thrombocytopenia depended on the type of surgery ( P < 0.0001). Mitral valve surgery, ascending aorta procedures, and the use of sutureless aortic valve prostheses were associated with increased thrombocytopenia rates. Platelet counts were higher in patients who have had off-pump coronary surgery within the first five days ( P < 0.0001). Five independent predictors were identified: older age ( P = 0.022), lower baseline platelet count ( P < 0.0001), higher creatinine ( P = 0.04), operative transfused units of red blood cells ( P = 0.015), and higher autotransfusion volume ( P = 0.02). The model using only preoperative variables achieved an AUC of 0.83. Finally, thrombocytopenia <100 G/L was associated with more blood loss ( P = 0.001), more postoperative transfusions ( P < 0.0001), and longer intensive care unit stay ( P = 0.001). CONCLUSION: Our study differentiates pre- and perioperative risk factors for thrombocytopenia in cardiac surgery to define a targeted, individualized platelet management strategy.
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BibTeX
@article{haszon2026thrombocytopenia,
title = {{Thrombocytopenia After Cardiac Surgery: A Single-Center Retrospective Study}},
author = {David Haszon and Sahar Abdallah and Qingyan Jia and Thibaut Lutz and Stéphane Santiago and Marius Tifrea and Lucie Chastaingt and Jérome Jouan and David Vandroux},
journal = {Annals of Cardiac Anaesthesia},
year = {2026},
month = jul,
doi = {10.4103/aca.aca_367_25},
url = {https://hal.science/hal-05770919v1},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Thrombocytopenia After Cardiac Surgery: A Single-Center Retrospective Study
AU - David Haszon
AU - Sahar Abdallah
AU - Qingyan Jia
AU - Thibaut Lutz
AU - Stéphane Santiago
AU - Marius Tifrea
AU - Lucie Chastaingt
AU - Jérome Jouan
AU - David Vandroux
PY - 2026
DA - 2026/07/29
JO - Annals of Cardiac Anaesthesia
DO - 10.4103/aca.aca_367_25
UR - https://hal.science/hal-05770919v1
AB - BACKGROUND: Postoperative thrombocytopenia is a frequent complication in cardiac surgery, associated with increased morbidity and mortality. Our study aimed to describe platelet count after cardiac surgery and identify predictors of postoperative thrombocytopenia. METHODS: We conducted a retrospective, single-center study including 519 adult patients who underwent cardiac surgery without operative platelet transfusion. The primary outcome was the incidence of postoperative thrombocytopenia, defined using three thresholds: <150 G/L, <100 G/L, and <50 G/L. Platelet counts were recorded daily from preoperative day to postoperative day 7. Independent predictors were identified using multivariate logistic regression for a threshold of 100 G/L. RESULTS: Thrombocytopenia < 150 G/L occurred in 306 patients (59%), <100 G/L in 92 (18%), and < 50 G/L in 35 (7%). The incidence of thrombocytopenia depended on the type of surgery ( P < 0.0001). Mitral valve surgery, ascending aorta procedures, and the use of sutureless aortic valve prostheses were associated with increased thrombocytopenia rates. Platelet counts were higher in patients who have had off-pump coronary surgery within the first five days ( P < 0.0001). Five independent predictors were identified: older age ( P = 0.022), lower baseline platelet count ( P < 0.0001), higher creatinine ( P = 0.04), operative transfused units of red blood cells ( P = 0.015), and higher autotransfusion volume ( P = 0.02). The model using only preoperative variables achieved an AUC of 0.83. Finally, thrombocytopenia <100 G/L was associated with more blood loss ( P = 0.001), more postoperative transfusions ( P < 0.0001), and longer intensive care unit stay ( P = 0.001). CONCLUSION: Our study differentiates pre- and perioperative risk factors for thrombocytopenia in cardiac surgery to define a targeted, individualized platelet management strategy.
SN - 0971-9784
ER -