A five-minute drainage assessment prevents reexploration for bleeding

Objective

To evaluate the effectiveness of the five-minute drainage assessment (FMDA) in preventing reexploration for bleeding following cardiovascular surgery.

Methods

This retrospective review included 1280 patients who underwent cardiovascular surgery between January 2017 and August 2021. Patients were divided into control (n = 695) and FMDA (n = 585) groups. The FMDA involved estimating the bleeding volume from 1 drainage tube every 5 minutes during sternal closure. Reexploration rates, postoperative bleeding volumes, and clinical outcomes were compared between the 2 groups.

Results

The FMDA group had a significantly lower rate of reexploration for bleeding than the control group (2.2% vs 4.3%; P = .038). The median postoperative bleeding volume within 24 hours was significantly lower in the FMDA group compared to controls (630 mL vs 695 mL; P = .009). Multivariable logistic regression analysis demonstrated that the FMDA was independently associated with a reduced risk of reexploration for bleeding (odds ratio, 0.49; 95% confidence interval, 0.25-0.96; P = .037). The FMDA demonstrated good discriminatory ability for identifying patients at risk of reexploration (area under the receiver operating characteristic curve = 0.782), with an optimal cutoff of 21.0 mL.

Conclusions

Implementation of the FMDA was associated with a significantly lower rate of reexploration for bleeding compared to the control group. The FMDA provides a simple and reproducible approach that can be readily adopted in surgical practice.