Risk scoring for prediction of postoperative bleeding in cardiac surgery

Background

Morbidity and mortality after cardiac surgery can be caused by excessive bleeding which is a common and preventable cause. Excessive bleeding after cardiac operations can be classified to surgical or medical causes. The Papworth Bleeding Risk Score can be helpful in predicting the high risk patients for excessive bleeding.

The objective of this study was the evaluation of the ability of Papworth Bleeding Risk Score for prediction of excessive early bleeding after cardiac surgery in Egypt.

Methods

In this prospective single-center observational study carried out from September 2017 till December 2017, at National Heart Institute of Egypt enrolled 100 consecutive patients.

Adult patients who were plnned to undergo cardiac surgery with cardiopulmonary bypass were included. Exclusion criteria were Off pump surgeries, congenital heart diseases and known bleeding disorders. The aim was to identify patients with expected risk of an adverse excessive postoperative bleeding according to Papworth bleeding risk score. Postoperative bleeding, reopening and death were calculated.

Results

Total number of the bleeders were 17 cases, (4 high risk, 11 medium risk and 2 low risk). Three patients were reopened with only one patient because of surgical cause.

Conclusions

We consider this bleeding score as a simple, effective and discriminative modality to stratify cases into three risk groups to take the prophylactic measures with high risk patients and to avoid side effects of these measures in low risk patients.