Preoperative aspirin ingestion significantly increased chest-tube blood loss 12 hours after CABG compared to control (1,513 vs 916 ml; p=0.038) and increased transfusion requirements.
RCT (n=34)
Open-label
randomized
Does preoperative aspirin ingestion increase postoperative blood loss and transfusion requirements in patients undergoing CABG?
Preoperative aspirin ingestion significantly increases postoperative blood loss and transfusion requirements in patients undergoing CABG, supporting the recommendation to discontinue aspirin prior to cardiac procedures.
Absolute Event Rate: 1513% vs 916%
p-value: p=0.038
Thirty-four patients were entered into a non-blinded, randomized study to test the effect of preoperative aspirin ingestion on postoperative blood loss and transfusion requirements after coronary artery bypass grafting. Sixteen patients in the aspirin-treated group had significantly increased chest-tube blood loss 12 hours after operation (1,513 +/- 978 versus 916 +/- 482 ml; p = 0.038). In addition, aspirin users had significantly increased requirements for postoperative packed red blood cells (4.4 +/- 3.5 versus 1.8 +/- 1.3 units; p = 0.014), platelets (1.3 +/- 1.3 versus 0.2 +/- 0.4 six-donor units, p = 0.0049), and fresh-frozen plasma (3.6 +/- 5.0 versus 0.78 +/- 1.6 units; p = 0.042) transfusions. The only patients requiring reoperation for bleeding were in the aspirin-treated group (2 patients). Six patients were not entered into the randomized part of the study because of excessively prolonged post-aspirin bleeding times (greater than 10 minutes). This finding suggests that a subset of patients are particularly sensitive to aspirin and have significantly prolonged bleeding times after aspirin ingestion. We conclude that aspirin ingestion increases postoperative blood loss and transfusion requirements, and we recommend discontinuation of aspirin therapy before cardiac procedures.
Ferraris et al. (1988) conducted an RCT in Coronary artery bypass grafting (n=34). Preoperative aspirin ingestion vs. Control (no aspirin) was evaluated on Chest-tube blood loss 12 hours after operation (p=0.038). Preoperative aspirin ingestion significantly increased chest-tube blood loss 12 hours after CABG compared to control (1,513 vs 916 ml; p=0.038) and increased transfusion requirements.