The Factors Predicting Retroperitoneal Hematoma Following Intra- Aortic Balloon Pump Insertion Site Injury

Feridoun  Sabzi; Mohammad Rouzbahani; Atefeh Asadmobini; Reza  Heidari Moghaddam; Aghigh  Heydari

International Cardiovascular Research Journal

The Official Annually Journal of Cardiovascular Research Center, Shiraz University of Medical Sciences

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The Factors Predicting Retroperitoneal Hematoma Following Intra- Aortic Balloon Pump Insertion Site Injury

Author(s):

Feridoun Sabzi

¹,

Mohammad Rouzbahani²,

Atefeh Asadmobini

¹,

Reza Heidari Moghaddam¹,

Aghigh Heydari

^1,*

1Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, IR Iran

2Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, IR Iran *Corresponding

International Cardiovascular Research Journal:Vol. 15, issue 1; e101955

Published online:Mar 30, 2021

Article type:Research Article

Received:Feb 17, 2020

Accepted:Feb 08, 2021

How to Cite:Feridoun SabziMohammad RouzbahaniAtefeh AsadmobiniReza Heidari MoghaddamAghigh Heydari The Factors Predicting Retroperitoneal Hematoma Following Intra- Aortic Balloon Pump Insertion Site Injury.Int Cardiovasc Res J.15(1):e101955.

Abstract

Background:
Retroperitoneal Hematoma (RPH) is one of the most serious complications after Intra-Aortic Balloon Pump (IABP) insertion. Although advances in clinical experience regarding IABP insertion have led to a decrease in vascular complications such as RPH, its rate has remained considerably high.
Objectives:
This study aimed to evaluate the factors predicting RPH following IABP insertion site injury.
Methods:
This retrospective cohort study of 2508 patients undergoing off-pump Coronary Artery Bypass Graft (CABG) surgery over 4.5 years allowed the identification and evaluation of all patients with RPH. The patients were divided into with RPH and without RPH groups. RPH prediction was analyzed by multivariate stepwise logistic regression analysis. SPSS, version 22 (SPSS Inc., Chicago, IL) was used for statistical analysis.
Results:
RPH developed in 16 patients (overall prevalence: 0.63%), with the highest frequency in low ejection fraction patients (3%). Female gender, compartment syndrome, IABP insertion site, preoperative Clopidogrel usage, use of post-operative inotropic drugs, and body surface area were the predictors of RPH in multivariate analysis. Moreover, in-hospital mortality was significantly higher in the patients who had developed RPH compared to those who had not (50% vs. 1.9%, P = 0.004).
Conclusions:
RPH is a serious vascular access site complication of IABP, which has been associated with high morbidity and mortality. The current study findings indicated that such factors as female gender, BSA, IABP insertion site, preoperative Clopidogrel usage, IABP usage, and post-operative inotrope drugs use could predict RPH. Identification of RPH risk factors could in turn prevent this problem.

Keywords

Hemorrhage

Intra-Aortic Balloon Pumping

Risk factor

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