Five-Minute Drainage Assessment Reduces Reexploration for Bleeding
Author Information
Author(s): Yamashita Go MD, Hirao Shingo MD, PhD, Sugaya Atsushi MD, Sakai Jiro MD, Komiya Tatsuhiko MD, PhD
Primary Institution: Kurashiki Central Hospital
Hypothesis
Does the five-minute drainage assessment (FMDA) effectively prevent reexploration for bleeding following cardiovascular surgery?
Conclusion
The FMDA is associated with a significantly lower rate of reexploration for bleeding compared to the control group.
Supporting Evidence
- The FMDA group had a lower reexploration rate for bleeding (2.2% vs 4.3%).
- The median postoperative bleeding volume was lower in the FMDA group (630 mL vs 695 mL).
- Multivariable analysis showed that FMDA was independently associated with reduced reexploration risk (odds ratio, 0.49).
- The FMDA demonstrated good discriminatory ability for identifying patients at risk of reexploration (AUC = 0.782).
- 91.3% of FMDA patients met criteria for terminating surgery with a final volume ≤20 mL.
Takeaway
Using a quick drainage check during heart surgery can help doctors know if they need to go back in to fix bleeding, which is better for patients.
Methodology
This retrospective review analyzed 1280 patients who underwent cardiovascular surgery, comparing control and FMDA groups based on reexploration rates and postoperative outcomes.
Potential Biases
Surgeon bias may have influenced reexploration rates and adherence to FMDA criteria.
Limitations
The study's retrospective design may introduce selection bias, and the FMDA criteria were not strictly followed in all cases.
Participant Demographics
The mean age was 68.1 years, with 63.5% male participants.
Statistical Information
P-Value
.038
Confidence Interval
0.25-0.96
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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