Hawthorn Herb Increases the Risk of Bleeding after Cardiac Surgery: An Evidence-Based Approach
DOI:
https://doi.org/10.1532/hsf.1570Abstract
Objectives: Hawthorn extract consumption is becoming more widespread among the Jordanian population with cardiovascular disorders. We conducted this prospective observational longitudinal study to determine the impact of hawthorn extract on bleeding risk in patients who undergo cardiac surgery.Methods: A prospective observational study was performed on 116 patients who underwent cardiac surgery in the period between June 2014 and May 2015. Patients were divided into two groups: Group I (patients recently consumed hawthorn extract) and Group II (patients never consumed hawthorn extract). Endpoint measures included the rates of reopening to control bleeding, early mortality, duration of intensive care unit stay, total in-hospital stay period, and duration and amount of chest tube drainage.
Results: Hawthorn patients had a significantly higher rate of postoperative bleeding necessitating take back to the operating room compared to the control group (10% versus 1%;
P = .03) respectively. The overall mortality rate for group I and II was 4% and 0% respectively; P = .17. Chest tubes were kept in for longer times in group I compared to group II
(54 ± 14.6 versus 49 ± 14.7 hours respectively; P = .01). Group I stayed longer in the intensive care unit compared to group II (24 versus 22 hours respectively; P = .01). The total in-hospital stay period was comparable between the two groups.
Conclusion: Hawthorn extract consumption does increase the potential for bleeding and the amount of chest tube output after cardiac surgery.
References
Christensen MC, Dziewior F, Kempel A, von Heymann C. 2012. Increased chest tube drainage is
independently associated with adverse outcome after cardiac surgery. J Cardiothorac Vasc Anesth 26:46-51.
Dahmer S, Scott E. 2010. Health effects of hawthorn. Am Fam Physician 81:465-8.
Faraoni, D, Savan V, Levy JH, Theusinger OM, et al. 2013. Goal-directed coagulation management in the perioperative period of cardiac surgery. J Cardiothorac Vasc Anesth 27:1347-54.
Fong HH, Bauman JL, Hawthorn. 2002. J Cardiovasc Nurs 16:1-8.
Lee KR, Ring JC, Leggiadro RJ. 1995. Prophylactic antibiotic use in pediatric cardiovascular surgery: a survey of current practice. Pediatr Infect Dis J 14:267-9.
Lopes CT, Dos Santos TR, Brunori EH. 2015. Excessive bleeding predictors after cardiac surgery in adults: integrative review. J Clin Nurs 24:3046-62.
Miller AL. 1998. Botanical influences on cardiovascular disease. Altern Med Rev 3:422-31.
Omeish AF, Abbadi W, Ghanma IM, et al. 2011. Hospital-based study on the use of herbal medicine in patients with coronary artery disease in Jordan. J Pak Med Assoc 61:683-7.
Pittler MH, Schmidt K, Ernst E. 2003. Hawthorn extract for treating chronic heart failure: meta-analysis of randomized trials. Am J Med 114:665-74.
Shatoor AS, Soliman H, Al-Hashem F, Gamal BE, Othman A, El-Menshawy N. 2012. Effect of Hawthorn (Crataegus aronia syn. Azarolus (L)) on platelet function in albino Wistar rats. Thromb Res 130:75-80.
Stone GW, Clayton TC, Mehran R et al. 2012. Impact of major bleeding and blood transfusions after cardiac surgery: analysis from the Acute Catheterization and Urgent Intervention Triage strategY (ACUITY) trial. Am Heart J 163:522-9.
Thiele RH, Raphael J. A 2014 update on coagulation management for cardiopulmonary bypass. Semin Cardiothorac Vasc Anesth 18:177-189.
Wang J, Xiong X, Feng B. 2013. Effect of crataegus usage in cardiovascular disease prevention: an evidence-based approach. Evid Based Complement Alternat Med 2013:149363.
Weihmayr T, Ernst E. 1996. Therapeutic effectiveness of Crataegus. Fortschr Med 114:27-9.
