Predictive Factors for Bleeding Risk in Patients Undergoing Valvular Surgery.

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.