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Updated: Jun 9, 2025

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Predictive Factors for Bleeding Risk in Patients Undergoing Valvular Surgery

Alef de Carvalho Vieira1, Renato Tambellini Arnoni1,2, Ana Beatriz Silva Barbosa1

  • 1Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brasil.

Arquivos Brasileiros De Cardiologia
|October 23, 2024
PubMed

Insights

Postoperative bleeding after heart valve surgery is a significant risk. This study identified tricuspid insufficiency, cardiopulmonary bypass time, and preoperative hemoglobin as key predictors for bleeding risk.

Area of Science:

  • Cardiovascular Surgery
  • Anesthesiology
  • Critical Care Medicine

Background:

  • Postoperative bleeding is a major complication following heart valve surgery.
  • This risk increases morbidity and mortality, posing a significant challenge in patient management.

Purpose of the Study:

  • To develop and validate a predictive risk score for postoperative bleeding in patients undergoing heart valve surgery.
  • To identify key clinical factors associated with increased bleeding risk.

Main Methods:

  • Retrospective analysis of 525 patients who underwent valve surgery between 2021 and 2022.
  • Logistic regression analysis was employed to identify bleeding risk factors, with statistical significance set at p<0.05.
  • A nomogram was developed based on statistically significant variables.

Main Results:

  • Tricuspid insufficiency (OR 3.31), chronic kidney disease/acute kidney injury (OR 2.97), reoperations (OR 2.5), and use of packed red blood cells (OR 2.8) were associated with increased bleeding.
  • Cardiopulmonary bypass (CPB) time (OR 1.12) and a 2-valve approach (OR 2.23) also showed significant associations.
  • Preoperative hemoglobin (OR 0.73) was found to be a protective factor against bleeding.

Conclusions:

  • Cardiopulmonary bypass time, preoperative hemoglobin levels, and tricuspid insufficiency are independent predictors of postoperative bleeding.
  • The developed risk score demonstrates plausibility and potential utility in predicting bleeding risk in cardiac surgery patients.
Abstract

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