Related Experiment Video
Updated: Oct 17, 2025
Complete and Partial Resuscitative Endovascular Balloon Occlusion of the Aorta for Hemorrhagic Shock
Published on: May 19, 2022
Reoperation for bleeding in an elective cardiac surgical population - Does it affect survival?
Saddiq Mohammad Qazi1, Kristian Kandler1, Peter Skov Olsen1
1Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen, Denmark.
Insights
Re-operation for bleeding after cardiac surgery significantly lowers both short-term and long-term survival. Meticulous hemostasis during initial surgery is crucial to prevent re-operations and improve patient outcomes.
Area of Science:
- Cardiothoracic Surgery
- Surgical Outcomes
- Patient Survival
Background:
- Re-operation for bleeding post-cardiac surgery is linked to adverse outcomes.
- Previous studies indicate increased mortality and morbidity in both acute and elective cases.
Purpose of the Study:
- To evaluate the impact of re-operation for bleeding on short- and long-term survival.
- To identify the causes of re-operation in an elective cardiac surgery population.
Main Methods:
- Single-center, retrospective study of 11,813 elective cardiac surgery patients (1998-2014).
- Comparison of outcomes between re-operated (RO) and non-re-operated (NRO) groups.
- Data collected from electronic patient records, including demographics, risk factors, and surgical details.
Main Results:
- 5.3% of patients (626) required re-operation for bleeding.
- Median survival was lower in the RO group (142 vs. 160 months, P=0.001).
- The RO group experienced significantly higher morbidity and 30-day mortality, with an increased age-adjusted risk of death (HR 1.21, P=0.003).
Conclusions:
- Re-operation for bleeding negatively impacts both short- and long-term survival in elective cardiac surgery.
- Surgical causes for bleeding were identified in most re-operations.
- Emphasizes the critical importance of achieving meticulous hemostasis during primary cardiac procedures.
Abstract:
Earlier studies have shown that re-operation for bleeding after cardiac surgery is associated with increased mortality and morbidity in both acute and elective patients. The aim of the study was to assess the effect of re-operation for bleeding on short- and long-term survival and the causes of re-operation on an exclusively elective population. This was a single-center, retrospective study conducted at the Department of Cardiothoracic Surgery at Copenhagen University Hospital. Rigshospitalet, Denmark. We included all elective patients undergoing first-time coronary bypass, valve surgery or combinations hereof between January 1998 and February 2014. Data was obtained from the electronic patient records on demographics, cardiological risk profile, blood transfusion and surgical record. A total of 11813 patients were included in the analysis of whom 626 (5.3%) patients underwent re-operation for bleeding. Patients were divided into two groups; non re-operated (NRO) and re-operated(RO). Baseline characteristics were comparable. Median survival was lover in the RO group (142 vs 160months (P = 0.001)). Morbidity and 30 day mortality was significantly higher in the RO group. Cox-regression analysis showed a significantly increased age-adjusted risk of death in the RO group (HR 1.21(1.07-1.37). P = 0.003). In 85% of the patients the site of bleeding was found during the re-operation. We found both short and long-term survival to be lower in the RO group. A surgical cause for re-operation was found in the majority of cases. The study shows the importance of meticulous hemostasis during cardiac surgery.
Related Concept Videos
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:22Aneurysm IV: Nursing Management