Universal definition of perioperative bleeding in adult cardiac surgery

Objectives - Perioperative bleeding is common among patients undergoing cardiac surgery; however, the definition of perioperative bleeding is variable and lacks standardization. We propose a universal definition for perioperative bleeding (UDPB) in adult cardiac surgery in an attempt to precisely de...

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Main Authors: Dyke, C., Aronson, S., Dietrich, W., Hofmann, Axel, Karkouti, K., Levi, M., Murphy, G., Sellke, F., Shore-Lesserson, L., von Heymann, C., Ranucci, M.
Format: Journal Article
Published: The American Association of Thoracic Surgery 2014
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/37769
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author Dyke, C.
Aronson, S.
Dietrich, W.
Hofmann, Axel
Karkouti, K.
Levi, M.
Murphy, G.
Sellke, F.
Shore-Lesserson, L.
von Heymann, C.
Ranucci, M.
author_facet Dyke, C.
Aronson, S.
Dietrich, W.
Hofmann, Axel
Karkouti, K.
Levi, M.
Murphy, G.
Sellke, F.
Shore-Lesserson, L.
von Heymann, C.
Ranucci, M.
author_sort Dyke, C.
building Curtin Institutional Repository
collection Online Access
description Objectives - Perioperative bleeding is common among patients undergoing cardiac surgery; however, the definition of perioperative bleeding is variable and lacks standardization. We propose a universal definition for perioperative bleeding (UDPB) in adult cardiac surgery in an attempt to precisely describe and quantify bleeding and to facilitate future investigation into this difficult clinical problem. Methods - The multidisciplinary International Initiative on Haemostasis Management in Cardiac Surgery identified a common definition of perioperative bleeding as an unmet need. The functionality and usefulness of the UDPB for clinical research was then tested using a large single-center, nonselected, cardiac surgical database. Results - A multistaged definition for perioperative bleeding was created based on easily measured clinical end points, including total blood loss from chest tubes within 12 hours, allogeneic blood products transfused, surgical reexploration including cardiac tamponade, delayed sternal closure, and the need for salvage treatment. Depending on these components, bleeding is graded as insignificant, mild, moderate, severe, or massive. When applied to an established cardiac surgery dataset, the UDPB provided insight into the incidence and outcome of bleeding after cardiac surgery. Conclusions - The proposed UDPB in adult cardiac surgery provides a precise classification of bleeding that is useful in everyday practice as well as in clinical research. Once fully validated, the UDPB may be useful as an institutional quality measure and serve as an important end point in future cardiac surgical research.
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publishDate 2014
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spelling curtin-20.500.11937-377692017-09-13T14:28:06Z Universal definition of perioperative bleeding in adult cardiac surgery Dyke, C. Aronson, S. Dietrich, W. Hofmann, Axel Karkouti, K. Levi, M. Murphy, G. Sellke, F. Shore-Lesserson, L. von Heymann, C. Ranucci, M. cardiac surgery Perioperative bleeding Objectives - Perioperative bleeding is common among patients undergoing cardiac surgery; however, the definition of perioperative bleeding is variable and lacks standardization. We propose a universal definition for perioperative bleeding (UDPB) in adult cardiac surgery in an attempt to precisely describe and quantify bleeding and to facilitate future investigation into this difficult clinical problem. Methods - The multidisciplinary International Initiative on Haemostasis Management in Cardiac Surgery identified a common definition of perioperative bleeding as an unmet need. The functionality and usefulness of the UDPB for clinical research was then tested using a large single-center, nonselected, cardiac surgical database. Results - A multistaged definition for perioperative bleeding was created based on easily measured clinical end points, including total blood loss from chest tubes within 12 hours, allogeneic blood products transfused, surgical reexploration including cardiac tamponade, delayed sternal closure, and the need for salvage treatment. Depending on these components, bleeding is graded as insignificant, mild, moderate, severe, or massive. When applied to an established cardiac surgery dataset, the UDPB provided insight into the incidence and outcome of bleeding after cardiac surgery. Conclusions - The proposed UDPB in adult cardiac surgery provides a precise classification of bleeding that is useful in everyday practice as well as in clinical research. Once fully validated, the UDPB may be useful as an institutional quality measure and serve as an important end point in future cardiac surgical research. 2014 Journal Article http://hdl.handle.net/20.500.11937/37769 10.1016/j.jtcvs.2013.10.070 The American Association of Thoracic Surgery unknown
spellingShingle cardiac surgery
Perioperative bleeding
Dyke, C.
Aronson, S.
Dietrich, W.
Hofmann, Axel
Karkouti, K.
Levi, M.
Murphy, G.
Sellke, F.
Shore-Lesserson, L.
von Heymann, C.
Ranucci, M.
Universal definition of perioperative bleeding in adult cardiac surgery
title Universal definition of perioperative bleeding in adult cardiac surgery
title_full Universal definition of perioperative bleeding in adult cardiac surgery
title_fullStr Universal definition of perioperative bleeding in adult cardiac surgery
title_full_unstemmed Universal definition of perioperative bleeding in adult cardiac surgery
title_short Universal definition of perioperative bleeding in adult cardiac surgery
title_sort universal definition of perioperative bleeding in adult cardiac surgery
topic cardiac surgery
Perioperative bleeding
url http://hdl.handle.net/20.500.11937/37769