Antithrombin concentrates may benefit cardiopulmonary bypass patients with suspected heparin resistance: A retrospective analysis of real-world data

BackgroundHeparin resistance is a common complication of surgical patients requiring anticoagulation, such as those undergoing cardiopulmonary bypass (CPB). Treatments to address heparin include supplementation antithrombin (AT) or fresh frozen plasma (FFP). This retrospective database analysis compared key outcomes in suspected heparin-resistant CPB treated with AT FFP.MethodsDe-identified United States electronic health records (Cerner Health Facts®) were queried. International Classification Diseases (ICD-9/10) codes used determine procedures and FFP administration. administration was identified using medication data, while combination lab data examining activated clotting times detected patients. Adult inpatients (≥18 years old) seen between 2001 2018 included. Differences mortality, intensive care unit (ICU) length stay (LOS), hospital-free days (using 30-day post-discharge period) assessed univariate models well adjusted logistic regression controlling for patient characteristics Charlson Comorbidity Index (CCI) scores.ResultsOf the 502 identified, 247 received 255 FFP. The cohort associated higher CCI (3.3 ± 2.4 vs. 2.3 2.0, P < .001). 71% (Odds Ratio [OR]: 0.29, 95% Confidence Interval [CI]: = .003) 66% (OR: 0.34, CI: .01) reduction mortality when models, respectively. Similarly, use also showed 22% shorter ICU LOS (P .02) 10% more 30 following discharge .004) according though statistical significance absent within both .08) .53).ConclusionsCompared FFP, suggests odds CPB, larger prospective studies are necessary elucidate potential differences across treatment modalities.