[Investigation of massive bleeding at Jichi Medical University Hospital]

We investigated the patients suffering from massive bleeding at the central surgical center, Jichi Medical University Hospital from April 2006 to March 2007. Of the 6401 patients who underwent surgical procedures, 72 patients (1%) received intraoperatively blood transfusion of more than 1400 ml (RCC-MAP Japan Red Cross). Of the 72 patients, 15 patients died within one month after surgery. Massive blood loss occurred during thoracoabdominal aortic aneurysm surgery (32 cases, 44%), major liver resections (10 cases, 14%), and surgical procedures in the pelvic organs (8 cases, 11%). Preoperative circulatory shock state affected the prognosis of the patients. The minimal hemoglobin concentration during anesthesia was significantly lower in the cases with worse prognoses than in those with recovery from illness, while amount of intraoperative blood loss, amount of blood transfusion, hemoglobin concentration before anesthesia or presence of blood coagulopathy did not influence the postoperative course of the patients.