Artikel
Prediction of postoperative bleeding complications using a standardized questionnaire regarding bleeding history for preoperative identification of patients with impaired hemostasis in elective neurosurgery: useful tool or waste of time? A prospective observational single-center study
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Autoren
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Valeri Borger
- Klinik für Neurochirurgie, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn
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Patrick Schuss
- Klinik für Neurochirurgie, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn
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Hartmut Vatter
- Klinik für Neurochirurgie, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn
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Erdem Güresir
- Klinik für Neurochirurgie, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn
| Veröffentlicht: | 2. Juni 2015 |
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Gliederung
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Objective: An assessment of the bleeding history including a standardized questionnaire (SQ) is established in several studies as a reliable tool for identifying patients with increased risk of perioperative bleeding complications in general surgery. However, there is a lack of data for neurosurgical patients. Therefore the aim of this study was to evaluate the feasibility of a SQ regarding bleeding history for the identification of patients with increased risk for postoperative bleeding complications after elective neurosurgical procedures.
Method: A total of 2088 patients was admitted for elective surgery in our neurosurgical department from 08/2013 to 10/2014. 1025 patients scheduled for elective neurosurgical procedures and with completed SQ were included in this prospective study. Standard coagulation tests were assessed routinely before the operation. All surgical procedures were performed under general anaesthesia. Patients were observed clinically and if deterioration was observed, further radiological evaluation was performed. Postoperative bleeding was defined as significant if surgical evacuation was required.
Results: A total of 1025 patients was included in this study. 506 (49.4%) were men with a mean age of 57 ± 18 years, and 519 (50.6%) were women with a mean age of 58 ± 17 years. 515 (50.2%) patients underwent intracranial (IP), 313 (30.5%) spinal (SP), and 197 (19.3%) other neurosurgical procedures. Postoperative bleeding complications occurred in 18 (1.8%) of 1025 patients. Four of the 18 patients (22%) had undergone SP, and 12 patients (66.6%) had undergone IP. Of these 18 patients, a positive bleeding history was apparent in no patient with an IP (0 of 12 patients), but in 2 of the 4 patients (50%) with SP (0% vs. 50%, p=0.009). The standard coagulation tests were not impaired in both, patients with bleeding complications and without.
Conclusions: The results of our prospective study show no correlation between the occurrence of postoperative bleeding complications and positive bleeding history in patients with IP and SP.
