Haneya, Assad and Diez, Claudius and Kolat, Philipp and von Suesskind-Schwendi, Marietta and Ried, Michael and Schmid, Christof and Hirt, Stephan W. (2015) Re-Exploration for Bleeding or Tamponade after Cardiac Surgery: Impact of Timing and Indication on Outcome. THORACIC AND CARDIOVASCULAR SURGEON, 63 (1). pp. 51-57. ISSN 0171-6425, 1439-1902
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Objectives Re-exploration after cardiac surgery remains a frequent complication with adverse outcomes. The aim of this study was to evaluate the impact of timing and indication of re-exploration on outcome. Methods A retrospective, observational study on a cohort of 209 patients, who underwent re-exploration after cardiac surgery between January 2005 and December 2011, was performed. The cohort was matched for age, gender, and procedure with patients who were not re-explored during the same period. Results The intraoperative and postoperative transfusion requirements were higher in the re-exploration group (p < 0.01). Patients in the re-exploration group had significantly higher incidences of postoperative acute renal injury (10.0 vs. 3.3%), sternal wound (9.1 vs. 2.4%) and pulmonary (13.4 vs. 4.3%) infections, longer ventilation time (22 [range, 14-52] vs. 12 [range, 9-16] hours) and intensive care unit stay (5 [range, 3-7] vs. 2 [range, 2-4] days), and higher mortality rate (9.6 vs. 3.3%). However, the multivariate logistic regression analysis demonstrated that not the re-exploration itself, but the deleterious effects of re-exploration (blood loss and transfusion requirement) were independent risk factors for mortality. Mortality was 5.3% for patients who were re-explored within the first 12 hours and 20.3% for patients who were re-explored after 12 hours (p = 0.003). Mortality was 3.6% for patients with bleeding and 31.4% for patients with cardiac tamponade for indication of re-exploration (p < 0.001). Conclusions This study suggests that re-exploration after cardiac surgery is associated with increased mortality and morbidity. Patients with delayed re-exploration and suffering from cardiac tamponade have adverse outcome.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ARTERY-BYPASS SURGERY; PERICARDIAL-EFFUSION; ADVERSE OUTCOMES; TRANSFUSION; RISK; REEXPLORATION; re-exploration; bleeding; tamponade; cardiac surgery |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 25 Jul 2019 09:00 |
| Last Modified: | 25 Jul 2019 09:00 |
| URI: | https://pred.uni-regensburg.de/id/eprint/6065 |
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