[Risk factors for excessive bleeding in patients undergoing open heart surgery with cardiopulmonary bypass].

OBJECTIVE

To evaluate the pre- and intraoperative risk factors associated with excessive bleeding during the perioperative period in adult patients undergoing open heart surgery with cardiopulmonary bypass (CPB).

METHODS

A total of 1079 consecutive patients undergoing open heart surgery with CPB from January 2001 to May 2010 were included (except for emergency operation). The possible risk factors associated with excessive bleeding were retrospectively analyzed. Patients who received ≥ 7 units of RBC or had a re-operation during which no active bleeding point was found within one day of operation were classified as excessive bleeding. According to the occurrence of excessive bleeding, they were divided into 2 groups: excessive and non-excessive bleeding groups. The possible risk factors associated with excessive bleeding were retrospectively analyzed. Univariate analysis and multivariate Logistic regression analysis were used to examine the relationship between these factors and excessive bleeding.

RESULTS

Among them, 120 (11.1%) developed excessive bleeding. Multivariate Logistic analysis indicated that the risk factors for excessive bleeding were age (OR = 4.533, 95%CI 2.624 - 7.831), previous sternotomy (OR = 2.781, 95%CI 1.410 - 5.486), preoperative hematocrit concentration (OR = 0.896, 95%CI 0.861 - 0.932), CPB duration (OR = 2.782, 95%CI 1.791 - 4.322) and type of procedure (OR = 2.292, 95%CI 1.376 - 3.817).

CONCLUSION

Age ≥ 65 years, previous sternotomy, preoperative low hematocrit concentration, CPB duration ≥ 120 min and complex operation were the significant predictors for excessive bleeding in patient undergoing open heart surgery with CPB.