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Complete and Partial Resuscitative Endovascular Balloon Occlusion of the Aorta for Hemorrhagic Shock

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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.

Journal of Cardiovascular and Thoracic Research

|October 11, 2021

Summary

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.

Keywords:

Cardiac Surgery Postoperative Bleeding Transfusions

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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.