Perioperative bleeding and outcomes after noncardiac surgery

Area of Science:

• Surgery
• Anesthesiology
• Critical Care Medicine
• Cardiology

Background:

• Perioperative bleeding is a significant complication following noncardiac surgery.
• Identifying its frequency, patient characteristics, causes, and outcomes is essential for patient safety.

Purpose of the Study:

• To determine the incidence of perioperative bleeding in patients undergoing noncardiac surgery.
• To analyze patient demographics, comorbidities, and outcomes associated with perioperative bleeding.

Main Methods:

• Retrospective cohort study using a large administrative database.
• Inclusion of adult patients (≥45 years) hospitalized for noncardiac surgery in 2018.
• Definition of perioperative bleeding using ICD-10 codes; assessment of clinical characteristics, in-hospital outcomes, and 6-month readmissions.

Main Results:

• 1.54% of 2,298,757 patients experienced perioperative bleeding.
• Bleeding patients were older, more likely male, with renal and cardiovascular disease, and had higher in-hospital mortality (6.0% vs 1.3%).
• Patients with bleeding had longer hospital stays and increased 6-month readmission rates (36.0% vs 23.6%).

Conclusions:

• Perioperative bleeding occurs in 1.54% of noncardiac surgeries, with increased risk in patients with elevated cardiovascular risk.
• One in three patients with perioperative bleeding died or were readmitted within 6 months.
• Strategies to mitigate perioperative bleeding are necessary to enhance outcomes in noncardiac surgery.