PACE DRAP: a simple score for predicting significant bleeding complications after cardiac implantable electronic device surgery.

Abstract

INTRODUCTION:

Currently, no risk score for predicting significant bleeding complications (SBCs) after cardiac implantable electronic device (CIED) surgery is available.

OBJECTIVES:

We aimed to develop a new scoring system for predicting SBCs aft er CIED surgery.

PATIENTS AND METHODS:

The incidence of SBCs was 4.5%. Based on multivariable analyses, the following predictors of SBCs were identified: age ≥75 years (odds ratio [OR], 8.10; 95% CI, 3.54-18.54); cardiac resynchronization therapy or implantable cardioverter-defibrillator surgery (OR, 5.96; 95% CI, 2.48-14.32); upgrade procedure (OR, 10.22; 95% CI, 4.05-25.78); uncontrolled arterial hypertension (OR, 4.82; 95% CI, 1.78-13.06); presence of valvular prosthesis (OR, 7.85; 95% CI, 3.15-19.58); current malignancy (OR, 6.11; 95% CI, 1.81-20.66); renal failure (OR, 4.28; 95% CI, 1.86-9.87); and the use of antiplatelet drugs (clopidogrel [OR, 6.69; 95% CI, 2.48-18.04] or ticagrelor [OR, 22.25; 95% CI, 4.56-108.46]). The score was created using the weighted points proportional to the β regression coefficient of each predictor rounded to the nearest integer, and the acronym PACE DRAP corresponds to the predictor's first letter. The cutoff point for the high risk of SBCs was 6 points with a sensitivity of 88.24% and a specificity of 87.23%. The PACE DRAP showed good predictive ability (area under the curve, 0.95 ; P <0.001).

CONCLUSIONS:

The PACE DRAP score is useful in identifying patients at high risk for SBCs after CIED surgery.

• Authors: Sylwia Sławek-Szmyt, Aleksander Araszkiewicz, Marek Grygier, Krzysztof Szmyt, Wojciech Seniuk, Michał Waśniewski, Tomasz Smukowski, Lidia Chmielewska-Michalak, Maciej Lesiak, Przemysław Mitkowski
• Journal: Polish archives of internal medicine (Pol Arch Intern Med) Vol. 130 Issue 3 Pg. 206-215 (03 27 2020) ISSN: 1897-9483 [Electronic] Poland
• PMID: 32026850 (Publication Type: Journal Article)

Chemical References

• Platelet Aggregation Inhibitors

Topics

• Age Factors
• Aged
• Aged, 80 and over
• Cardiac Resynchronization Therapy Devices
• Cardiac Surgical Procedures (adverse effects)
• Defibrillators, Implantable
• Female
• Hemorrhage (epidemiology, etiology)
• Humans
• Hypertension
• Male
• Middle Aged
• Neoplasms
• Platelet Aggregation Inhibitors
• Poland
• Prospective Studies
• Renal Insufficiency
• Risk Assessment