Related Experiment Video
Updated: May 4, 2026
A New Hybrid Quantitative Evaluation Model for Axillary Junctional Hemorrhage in Swine
Published on: December 6, 2024
Multivariate model for predicting postoperative blood loss in children undergoing cardiac surgery: a preliminary
V Savan1, A Willems, D Faraoni
1Department of Anaesthesia and Intensive Care 'Valeriu Ghereg', State Medical and Pharmaceutical University 'Nicolae Testemitanu', Chisinau, Republic of Moldova.
Insights
Predicting postoperative bleeding in children after cardiac surgery is crucial. Preoperative body weight, cyanotic disease, and wound closure time are key predictors, helping estimate bleeding risk.
Area of Science:
- Pediatric Cardiac Surgery
- Hemostasis and Thrombosis
Background:
- Postoperative bleeding and blood transfusions are significant concerns after pediatric cardiac surgery, impacting patient outcomes and healthcare costs.
- Predictive factors for bleeding in this population remain understudied.
Purpose of the Study:
- To identify factors that accurately predict postoperative bleeding in children undergoing congenital heart surgery.
- To develop a predictive model for estimating individual bleeding risk.
Main Methods:
- A cohort of 182 children undergoing congenital heart surgery was analyzed.
- Significant bleeding was defined as >10% total blood volume loss within 6 hours post-surgery.
- Univariate and multivariate logistic regression identified independent predictors of bleeding.
Main Results:
- Factors independently associated with postoperative bleeding included preoperative body weight, presence of cyanotic disease, and wound closure duration.
- A predictive model incorporating these factors demonstrated a significant relationship with bleeding.
- A probability threshold of 0.59 achieved 84% sensitivity and 64% specificity for predicting significant blood loss.
Conclusions:
- Preoperative body weight, cyanotic disease, and wound closure duration are significant predictors of postoperative bleeding in pediatric cardiac surgery.
- Combining these factors allows for an estimation of individual bleeding probability post-surgery.
Background:
Postoperative bleeding and blood product transfusion increase morbidity, mortality, and costs after cardiac surgery. However, factors that could accurately predict bleeding have not been well studied in children undergoing cardiac surgery. This study aims at determining factors that could be used to predict postoperative bleeding in this paediatric population.
Methods:
We included 182 children undergoing congenital heart surgery. Significant bleeding was defined as a blood loss that exceeds 10% of total blood volume within the first 6 postoperative hours. Univariate and multivariate logistic regression analyses were performed to determine variables independently associated with bleeding. These variables were used to calculate a probability for each individual child to develop postoperative bleeding.
Results:
According to the definition of bleeding, 44 patients were included into the 'bleeder' group and 138 into the 'non-bleeder' group. Factors independently associated with postoperative bleeding were preoperative body weight, the presence of a cyanotic disease, and the time required for wound closure. Based on these three parameters, we calculated the probability of bleeding and found a significant relationship with postoperative bleeding. Finally, a calculated probability of 0.59 can predict significant postoperative blood loss with a sensitivity of 84% and a specificity of 64%.
Conclusions:
This study shows that preoperative body weight, cyanotic disease, and wound closure duration are best predictors of bleeding in the paediatric population after cardiac surgery. The combination of these three factors could be used at the end of the surgery to estimate the probability of postoperative bleeding.
