Related Experiment Videos
Unplanned reoperation for bleeding
1Department of Surgery, Family Health Plan Cooperative, Milwaukee, Wisconsin, USA.
The American Surgeon
|January 1, 1996
Summary
Postoperative bleeding after elective surgery, especially diffuse bleeding, is often linked to aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs). Routine coagulation tests do not predict this bleeding risk.
Area of Science:
- Surgical Outcomes
- Pharmacology
Background:
- Postoperative bleeding is a significant complication following elective surgery.
- Routine coagulation screening may not identify all patients at risk for bleeding.
Purpose of the Study:
- To investigate the causes and consequences of postoperative bleeding after elective surgery.
- To determine the association between preoperative medication use and postoperative bleeding.
Main Methods:
- Retrospective review of 6499 elective surgical procedures.
- Analysis of patients requiring reoperation for bleeding control.
- Correlation of bleeding patterns with preoperative medication history, specifically aspirin and NSAIDs.
Main Results:
- Thirty patients (0.46%) required reoperation for bleeding.
- Diffuse bleeding occurred in 20 patients (0.31%) and was strongly associated with preoperative aspirin or NSAID use (95%).
- Discrete bleeding sites were not associated with these medications (P < 0.001).
- Diffuse bleeding led to increased reoperations, longer hospital stays, higher intensive care unit utilization, and increased costs.
- Routine coagulation profiles did not predict bleeding risk.
Conclusions:
- Preoperative use of aspirin and NSAIDs is a significant risk factor for diffuse postoperative bleeding.
- Identifying patients on these medications and potentially delaying surgery is advisable.
- Postoperative bleeding, particularly diffuse types, substantially increases healthcare resource utilization and costs.