Risk factors for the development of retroperitoneal hematoma after percutaneous coronary intervention in the era of glycoprotein IIb/IIIa inhibitors and vascular closure devices

We sought to determine the incidence, clinical features, and risk factors for retroperitoneal hematoma (RPH) after percutaneous coronary intervention (PCI). Little is known about the clinical features, outcomes, and determinants of this serious complication in the contemporary era of PCI. A retrospe...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 2005-02, Vol.45 (3), p.363-368
Main Authors: Farouque, H.M. Omar, Tremmel, Jennifer A., Raissi Shabari, Farshad, Aggarwal, Meenakshi, Fearon, William F., Ng, Martin K.C., Rezaee, Mehrdad, Yeung, Alan C., Lee, David P.
Format: Article
Language:English
Subjects:
Aged
Angioplasty, Balloon, Coronary - adverse effects
Biological and medical sciences
Body Surface Area
Cardiology
Cardiology. Vascular system
Case-Control Studies
Drug therapy
Female
Femoral Artery - surgery
Heart attacks
Hematoma - etiology
Hospitals
Humans
Male
Medical sciences
Middle Aged
Nephrology. Urinary tract diseases
Platelet Glycoprotein GPIIb-IIIa Complex - antagonists & inhibitors
Postoperative Hemorrhage - etiology
Retroperitoneal Space
Risk Factors
Suture Techniques
Urinary system involvement in other diseases. Miscellaneous
Urinary tract. Prostate gland
Veins & arteries
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Summary:We sought to determine the incidence, clinical features, and risk factors for retroperitoneal hematoma (RPH) after percutaneous coronary intervention (PCI). Little is known about the clinical features, outcomes, and determinants of this serious complication in the contemporary era of PCI. A retrospective analysis yielded 26 cases of RPH out of 3,508 consecutive patients undergoing PCI between January 2000 and January 2004. Cases were compared with a randomly selected sample of 50 control subjects without RPH. The incidence of RPH was 0.74%. Features of RPH included abdominal pain (42%), groin pain (46%), back pain (23%), diaphoresis (58%), bradycardia (31%), and hypotension (92%). The mean systolic blood pressure nadir was 75 mm Hg. The hematocrit dropped by 11.5 ± 5.1 points from baseline in RPH patients, as compared with 2.3 ± 3.3 points in controls (p < 0.0001). The mean hospital stay was longer in RPH patients (2.9 ± 3.8 days vs. 1.7 ± 1.5 days, p = 0.06). The following variables were found to be independent predictors of RPH: female gender (odds ratio [OR] 5.4, p = 0.005), low body surface area (BSA
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2004.10.042