Validation of the E-CABG Bleeding Severity Classification in Open Peripheral Arterial Surgery.

Area of Science:

• Vascular Surgery
• Surgical Outcomes Research
• Patient Safety

Background:

• Accurate documentation of perioperative bleeding is vital for vascular procedures.
• The European Multicenter Study on Coronary Artery Bypass Grafting (E-CABG) bleeding classification requires validation for open peripheral arterial surgery (OPAS).

Purpose of the Study:

• To validate the E-CABG bleeding classification system in patients undergoing OPAS.
• To assess the predictive capability of the E-CABG classification for adverse patient outcomes.

Main Methods:

• Prospective, multicenter cohort study of adult patients undergoing elective OPAS (excluding abdominal aortic surgery).
• Complications were categorized using the E-CABG grading system.
• Logistic regression analysis evaluated the prediction of Grade I or higher bleeding for patient outcomes, adjusted for OPAS type.

Main Results:

• 12% of 778 patients experienced bleeding complications (Grade I or II).
• Patients with Grade ≥ I bleeding had significantly higher rates of thrombo-embolic complications, myocardial infarction, graft thrombosis, wound infection, pneumonia, reoperation, and mortality.
• The E-CABG Grade ≥ I classification predicted 30-day mortality (AUC 0.81), reoperation (AUC 0.75), wound infection (AUC 0.76), and thrombo-embolic complications (AUC 0.67).

Conclusions:

• The E-CABG bleeding classification is applicable for stratifying bleeding severity in OPAS.
• The classification effectively predicts adverse short-term postoperative outcomes, supporting its use in research and registries.