Barry Dixon1, David Reid2, Marnie Collins3, Andrew E Newcomb4, Alexander Rosalion4, Cheng-Hon Yap5, John D Santamaria2, Duncan J Campbell6. 1. Department of Intensive Care, St. Vincent's Hospital, Melbourne, Australia. Electronic address: barry.dixon@svhm.org.au. 2. Department of Intensive Care, St. Vincent's Hospital, Melbourne, Australia. 3. Department of Statistics, Peter MacCallum Hospital, Melbourne, Australia. 4. Department of Cardiothoracic Surgery, St. Vincent's Hospital, Melbourne, Australia. 5. Department of Cardiothoracic Surgery, Geelong Hospital, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. 6. St. Vincent's Institute of Medical Research, St. Vincent's Hospital, Melbourne, Australia; Department of Medicine, University of Melbourne, St. Vincent's Hospital, Melbourne, Australia.
Abstract
OBJECTIVES: Bleeding into the chest is a major cause of blood transfusion and adverse outcomes following cardiac surgery. The authors investigated predictors of bleeding following cardiac surgery to identify potentially correctable factors. DESIGN: Data were retrieved from the medical records of patients undergoing cardiac surgery over the period of 2002 to 2008. Multivariate analysis was used to identify the independent predictors of chest tube drainage. SETTING: Tertiary hospital. PARTICIPANTS: Two thousand five hundred seventy-five patients. INTERVENTIONS: Cardiac surgery. RESULTS: The individual operating surgeon was independently associated with the extent of chest tube drainage. Other independent factors included internal mammary artery grafting, cardiopulmonary bypass time, urgency of surgery, tricuspid valve surgery, redo surgery, left ventricular impairment, male gender, lower body mass index and higher preoperative hemoglobin levels. Both a history of diabetes and administration of aprotinin were associated with reduced levels of chest tube drainage. CONCLUSIONS: The individual operating surgeon was an independent predictor of the extent of chest tube drainage. Attention to surgeon-specific factors offers the possibility of reduced bleeding, fewer transfusions, and improved patient outcomes.
OBJECTIVES:Bleeding into the chest is a major cause of blood transfusion and adverse outcomes following cardiac surgery. The authors investigated predictors of bleeding following cardiac surgery to identify potentially correctable factors. DESIGN: Data were retrieved from the medical records of patients undergoing cardiac surgery over the period of 2002 to 2008. Multivariate analysis was used to identify the independent predictors of chest tube drainage. SETTING: Tertiary hospital. PARTICIPANTS: Two thousand five hundred seventy-five patients. INTERVENTIONS: Cardiac surgery. RESULTS: The individual operating surgeon was independently associated with the extent of chest tube drainage. Other independent factors included internal mammary artery grafting, cardiopulmonary bypass time, urgency of surgery, tricuspid valve surgery, redo surgery, left ventricular impairment, male gender, lower body mass index and higher preoperative hemoglobin levels. Both a history of diabetes and administration of aprotinin were associated with reduced levels of chest tube drainage. CONCLUSIONS: The individual operating surgeon was an independent predictor of the extent of chest tube drainage. Attention to surgeon-specific factors offers the possibility of reduced bleeding, fewer transfusions, and improved patient outcomes.
Authors: Francesco Onorati; Augusto D'Onofrio; Fausto Biancari; Stefano Salizzoni; Marisa De Feo; Marco Agrifoglio; Giovanni Mariscalco; Vincenzo Lucchetti; Antonio Messina; Francesco Musumeci; Giuseppe Santarpino; Giampiero Esposito; Francesco Santini; Paolo Magagna; Cesare Beghi; Marco Aiello; Ester Dalla Ratta; Carlo Savini; Giovanni Troise; Mauro Cassese; Theodor Fischlein; Mattia Glauber; Giancarlo Passerone; Giuseppe Punta; Tatu Juvonen; Ottavio Alfieri; Davide Gabbieri; Domenico Mangino; Andrea Agostinelli; Ugolino Livi; Omar Di Gregorio; Alessandro Minati; Mauro Rinaldi; Gino Gerosa; Giuseppe Faggian Journal: Interact Cardiovasc Thorac Surg Date: 2016-03-14
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