To identify the risk factors of major bleeding in patients undergoing off-pump coronary artery bypass grafting(OPCAB).

Data on coronary artery disease patients who underwent off-pump CABG between December 2009 and December 2014 were reviewed. Baseline characteristics were compared between patients with clopidogrel discontinuation ≥5 days and <5 days. Univariate and multivariate logistic regression analyses were performed to investigate the risk factors of perioperative major bleeding. Major bleeding was defined as the Universal Definition of Perioperative Bleeding(UDPB) class 3-4.

A total of 3 988 patients who underwent OPCAB were included in this study. Major bleeding rate was 9.23%(n=368). Multivariable regression analysis showed that female sex(OR=1.99, 95%CI: 1.57-2.52), age(OR=1.02, 95%CI: 1.00-1.03), lower BMI(BMI≤25 kg/m²)(OR=1.40, 95%CI: 1.12-1.75), decreased GRF(GFR<60 ml/min)(OR=1.43, 95%CI: 1.01-2.02), decreased preoperative Hct(Hct<0.40)(OR=1.57, 95%CI: 1.23-1.99) and clopidogrel discontinuation <5 days(OR=1.97, 95%CI: 1.58-2.44) conferred a higher risk of perioperative major bleeding during OPCABG.

Female, advanced age, lower BMI, decreased GRF, decreased preoperative Hct and clopidogrel discontinuation<5 days are independent risk factors of perioperatice major bleeding in patients undergoing OPCAB. Predicting risk of major bleeding can help sugeons to optimize perioperative management.

Coronary artery bypass grafting, off pump Risk factors Perioperative Bleeding