Factors Associated with Groin Hematoma after Trans-femoral Percutaneous Coronary Intervention: A Study from Thai PCI Registry

Abstract

Background: Groin hematoma is a well-recognized and common complication after percutaneous coronary intervention (PCI) with trans-femoral approach (TFA). However, understanding of groin hematoma is lacked in Thailand. Objective: To study the incidence and factors associated with groin hematoma after PCI with TFA in recent practices among Thai PCI centers. Materials and Methods: Patients who were consecutively recruited into Thai PCI registry and had undergone PCI with TFA were included in the analysis. Various clinical and procedural variables were collected. Groin hematoma was defined as hematoma >5 cm. Univariate and multivariate logistic regression were performed. Results: Of 11,253 overall patients, 161 patients (1.43%) developed groin hematoma. Incidence of groin hematoma was slightly higher in patients with acute coronary syndrome (1.62%) compared with patients with stable coronary artery disease (1.21%). From statistical and clinical model multivariate analysis, older age (Odds ratio (OR) 1.02, 95% confidence interval (CI) 1.01 to 1.04, p=0.001, and OR 1.03, 95% CI 1.01 to 1.04, p=0.001), prolonged fluoroscopic time (OR 1.006, 95% CI 1.001 to 1.010; p=0.014, and OR 1.006, 95% CI 1.001 to 1.010, p=0.013), emergency or urgent PCI (OR 1.56, 95% CI 1.14 to 2.13, p=0.006, and OR 1.53, 95% CI 1.11 to 2.12, p=0.010), and more than one puncture (OR 2.89, 95% CI 1.90 to 4.39, p<0.001, and OR 2.84, 95% CI 1.87 to 4.31, p<0.001) were found to be significantly associated with groin hematoma, respectively. Closure device use was also significantly associated with groin hematoma from statistical model multivariate analysis (OR 1.66, 95% CI 1.03 to 2.66, p=0.038). Conclusion: In a large contemporary patient registry, incidence of groin hematoma after PCI with TFA was low. Most of predisposing factors for groin hematoma remained the same as traditional knowledges, except prolonged fluoroscopic time which was newly identified.