Re-exploration for hemorrhage following open heart surgery differentiation on the causes of bleeding and the impact on patient outcomes.

摘要: Objectives: To differentiate surgical bleeding requiring re-exploration from postoperative coagulopathy and determine the differences in patient outcomes. Methods: This was a retrospective chart review of 2,263 adult patients undergoing elective emergency open heart procedures encompassing coronary artery bypass, valvular, combined procedure to impact source leading re-exploration. Results: Eighty-two (3.6%) required Sixty-six percent had bleeding; remaining 34% were coagulopathic. Postoperative associated with preoperative heparin use (37% vs. 19.9% for controls p<0.05). Re-operative bypass/ valve (p<0.001) prolonged cardiopulmonary bypass aortic cross-clamp times (p<0.05) more prevalent group. inotrope increased who re-explored (p<0.001), as cardiac, pulmonary, renal abdominal complications all cases those medically related worse acute outcomes than group causes The hospital stay both (23.5 days) (27.1 compared not (12.0 days, p<0.001). Survival 91.3% bleeding, 87.5% coagulopathy, 98.0% others (p<0.01). Conclusions: Severe hemorrhage is significant morbidity mortality. stay, morbidity, mortality significantly suffering when causes. (Ann Thorac Cardiovasc Surg 2001; 7: 352‐7)