Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Impact of aprotinin and renal function on mortality: a retrospective single center analysis. | Schloss et al. Journal of Cardiothoracic Surgery 2011 6 103 http content 6 1 103 JCTS JOURNAL OF CARDIOTHORACIC SURGERY RESEARCH ARTICLE Open Access Impact of aprotinin and renal function on mortality a retrospective single center analysis 12 2 2 3 4 Brian Schloss Parul Gulati Lianbo Yu Mahmoud Abdel-Rasoul William O Brien Jon Von Visger and Hamdy Awad1 Abstract Background An estimated up to 7 of high-risk cardiac surgery patients return to the operating room for bleeding. Aprotinin was used extensively as an antifibrinolytic agent in cardiac surgery patients for over 15 years and it showed efficacy in reducing bleeding. Aprotinin was removed from the market by the . Food and Drug Administration after a large prospective randomized clinical trial documented an increased mortality risk associated with the drug. Further debate arose when a meta-analysis of 211 randomized controlled trials showed no risk of renal failure or death associated with aprotinin. However only patients with normal kidney function have been studied. Methods In this study we look at a single center clinical trial using patients with varying degrees of baseline kidney function to answer the question Does aprotinin increase odds of death given varying levels of preoperative kidney dysfunction Results Based on our model aprotinin use was associated with a increase in odds of death one year later compared to no aprotinin use with p-value regardless of level of preoperative kidney dysfunction after adjusting for other perioperative variables. Conclusions Lessons learned from our experience using aprotinin in the perioperative setting as an antifibrinolytic during open cardiac surgery should guide us in testing future antifibrinolytic drugs for not only efficacy of preventing bleeding but for overall safety to the whole organism using long-term clinical outcome studies including those with varying degree of baseline kidney function. Keywords complex .
