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. 2023 Jun 6:10:1091162.
doi: 10.3389/fsurg.2023.1091162. eCollection 2023.

Analysis of the risk factors for secondary hemorrhage after abdominal surgery

Tianshu Pang  1 , Zhengrong Wu  1 , Hongfen Zeng  2 , Xiangyu Zhang  1 , Mengya Hu  2 , Liping Cao  1
Affiliations

Analysis of the risk factors for secondary hemorrhage after abdominal surgery

Tianshu Pang et al. Front Surg. .

Abstract

Introduction: This study aimed to conduct a clinical review and analysis to recommend options for the prevention and treatment of postoperative hemorrhage.

Patients and methods: A total of 138 patients who experienced postoperative hemorrhage after abdominal surgery in the period between January 2015 and December 2020 at the Sir Run Run Shaw Hospital, affiliated to Zhejiang University School of Medicine, participated in this study. They were divided into a group with primary bleeding only and a secondary bleeding group. Univariate and multivariate statistical analyses were performed, followed by plotting of cumulative hazard and survival curves for the two groups.

Results: The main factors of interest found to be associated with secondary hemorrhage were duration of the operation, the time of the first bleeding incident, intervention time, performance of combined organ resection, use of surgical intervention, occurrence of abdominal infection, admission to the intensive care unit (ICU), postoperative length of stay, and total hospitalization expenses. Among these, a long operative duration (>5 h) and an extended intervention time (>5 h) were identified as independent predictors of risk of secondary hemorrhage.

Conclusions: Secondary hemorrhage after abdominal surgery is mainly associated with subjective human factors, and it is an important cause of poor prognosis and even death. Proper reductions in operation time and implementation of a quick response to bleeding are the key factors in tackling bleeding. Further reduction in the rates of postoperative hemorrhage and mortality will require a concerted effort by surgeons in terms of both intraoperative surgical techniques and postoperative management.

Keywords: abdominal surgery; bleeding; hemostasis; predictors; secondary hemorrhage.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Screening procedure of patients and hemostasis measures.
Figure 2
Figure 2
Survival function for patterns.
Figure 3
Figure 3
Hazard function for patterns.
See this image and copyright information in PMC

References

    1. Yekebas EF, Wolfram L, Cataldegirmen G, Habermann CR, Bogoevski D, Koenig AM, et al. Postpancreatectomy hemorrhage: diagnosis and treatment: an analysis in 1669 consecutive pancreatic resections. Ann Surg. (2007) 246(2):269–80. 10.1097/01.sla.0000262953.77735.db - DOI - PMC - PubMed
    1. Wei AC, Tung-Ping Poon R, Fan ST, Wong J. Risk factors for perioperative morbidity and mortality after extended hepatectomy for hepatocellular carcinoma. Br J Surg. (2003) 90(1):33–41. 10.1002/bjs.4018 - DOI - PubMed
    1. Brott T, Broderick J, Kothari R, Barsan W, Tomsick T, Sauerbeck L, et al. Early hemorrhage growth in patients with intracerebral hemorrhage. Stroke. (1997) 28(1):1–5. 10.1161/01.STR.28.1.1 - DOI - PubMed
    1. Liu C, Qiu YH, Luo XJ, Yi B, Jiang XQ, Tan WF, et al. Treatment of massive pancreaticojejunal anastomotic hemorrhage after pancreatoduodenectomy. World J Gastroenterol. (2009) 15(13):1625–9. 10.3748/wjg.15.1625 - DOI - PMC - PubMed
    1. Farley DR, Schwall G, Trede M. Completion pancreatectomy for surgical complications after pancreaticoduodenectomy. Br J Surg. (1996) 83(2):176–9. - PubMed

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