A five-minute drainage assessment prevents reexploration for bleedingCentral MessagePerspective
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. Patie...
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Elsevier
2024-12-01
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| Series: | JTCVS Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666273624002304 |
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| author | Go Yamashita, MD Shingo Hirao, MD, PhD Atsushi Sugaya, MD Jiro Sakai, MD Tatsuhiko Komiya, MD, PhD |
| author_facet | Go Yamashita, MD Shingo Hirao, MD, PhD Atsushi Sugaya, MD Jiro Sakai, MD Tatsuhiko Komiya, MD, PhD |
| author_sort | Go Yamashita, MD |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-06e9f3ad99e44bbdbb3ee2321f9fcccc |
| institution | Kabale University |
| issn | 2666-2736 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Open |
| spelling | doaj-art-06e9f3ad99e44bbdbb3ee2321f9fcccc2024-12-15T06:16:52ZengElsevierJTCVS Open2666-27362024-12-01226575A five-minute drainage assessment prevents reexploration for bleedingCentral MessagePerspectiveGo Yamashita, MD0Shingo Hirao, MD, PhD1Atsushi Sugaya, MD2Jiro Sakai, MD3Tatsuhiko Komiya, MD, PhD4Address for reprints: Go Yamashita, MD, Department of Cardiovascular Surgery, Kurashiki Central Hospital, 1-1-1 Miwa Kurashiki, Okayama 710-8602, Japan.; Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki, JapanDepartment of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki, JapanDepartment of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki, JapanDepartment of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki, JapanDepartment of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki, JapanObjective: 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.http://www.sciencedirect.com/science/article/pii/S2666273624002304reexplorationfive-minute drainage assessmentcardiovascular surgerytamponadebleeding |
| spellingShingle | Go Yamashita, MD Shingo Hirao, MD, PhD Atsushi Sugaya, MD Jiro Sakai, MD Tatsuhiko Komiya, MD, PhD A five-minute drainage assessment prevents reexploration for bleedingCentral MessagePerspective JTCVS Open reexploration five-minute drainage assessment cardiovascular surgery tamponade bleeding |
| title | A five-minute drainage assessment prevents reexploration for bleedingCentral MessagePerspective |
| title_full | A five-minute drainage assessment prevents reexploration for bleedingCentral MessagePerspective |
| title_fullStr | A five-minute drainage assessment prevents reexploration for bleedingCentral MessagePerspective |
| title_full_unstemmed | A five-minute drainage assessment prevents reexploration for bleedingCentral MessagePerspective |
| title_short | A five-minute drainage assessment prevents reexploration for bleedingCentral MessagePerspective |
| title_sort | five minute drainage assessment prevents reexploration for bleedingcentral messageperspective |
| topic | reexploration five-minute drainage assessment cardiovascular surgery tamponade bleeding |
| url | http://www.sciencedirect.com/science/article/pii/S2666273624002304 |
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