ArticleThe Annals of thoracic surgery2014
Recombinant factor VII is associated with worse survival in complex cardiac surgical patients.
Article in The Annals of thoracic surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- Incidence of Venous Thromboembolism and Benefits and Risks of Thromboprophylaxis After Cardiac Surgery: A Systematic Review and Meta-Analysis.Journal of the American Heart Association · 2015Pooled it
- Management of neonatal massive hemorrhage: A narrative review.Transfusion · 2026Review
- Rescue Therapy With Factor VII for Refractory Cardiac Surgical Bleeding: A Propensity-Score-Matched Study.Interdisciplinary cardiovascular and thoracic surgery · 2025Article
- Recombinant Activated Factor VII in Aortic Surgery for Patients Under Hypothermic Circulatory Arrest.Therapeutics and clinical risk management · 2022Article
- Recombinant activated factor VII for uncontrolled bleeding postcardiac surgery.Journal of the Saudi Heart Association · 2016Article
- Comparison of low- and high-dose recombinant activated factor VII for postcardiac surgical bleeding.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2016Article
- Recombinant Activated Factor VII Significantly Reduces Transfusion Requirements in Cardiothoracic Surgery.Drugs in R&D · 2015Article
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5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundRecombinant activated factor VII (rFVIIa) decreases requirements for allogeneic blood transfusion and chest reexploration in patients undergoing cardiac surgery. Whether rFVIIa increases the risk of postoperative adverse events is unclear. We tested whether rFVIIa administration was associated with increased mortality and neurologic and renal morbidity in patients undergoing cardiac surgery. Risk of thromboembolic complications and the dose-response of rFVIIa on mortality and morbidity were also evaluated.
methodsOf 27,977 patients who had complex cardiac surgery, 164 patients (0.59%) received rFVIIa perioperatively. Using propensity-matching techniques, patients were matched to a maximum of 3 control patients. Patients who received rFVIIa were compared with control patients on risk of mortality, neurologic and renal morbidity, and thromboembolic complications, including a composite of myocardial infarction, pulmonary embolism, and deep venous thrombosis. A corresponding dose-response analysis using multivariable logistic regression was also performed.
resultsPropensity techniques successfully matched 144 patients (88%) with 359 control patients. Of patients who received rFVIIa, 40% experienced in-hospital mortality compared with 18% of control patients (odds ratio, 2.82; 98.3% confidence interval, 1.64 to 4.87; p<0.001). Furthermore, 31% of patients treated with rFVIIa versus 17% of control patients experienced renal morbidity (odds ratio, 2.07; 98.3% confidence interval, 1.19 to 3.62; p=0.002); however, neurologic morbidity and thromboembolic complications were not different among groups. High-dose rFVIIa (>60 μg/kg) did not increase the risk for mortality compared with treatment with low-dose rFVIIa (<60 μg/kg).
conclusionsAdministration of rFVIIa is associated with increased mortality and renal morbidity in patients undergoing cardiac surgery.
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