Perioperative Bleeding Risk Factors
Preoperative Bleeding Risk Factors:
- Prior bleeding history following surgical procedures
- Preop coagulopathy
- Preoperative organ dysfunction
- Liver disease
- Kidney disease/renal failure
- CHF with passive liver congestion
- increased LFTs
- increased PT
- History of quantitive or qualitative platelet dysfunction
- Platelet inhibitors
- ASA, NSAID
- GPIIb/IIIa inhibitor
- Preop anticoagulant use
- Heparin
- Warfarin
- Fibrinolytic administration
- TPA
- Streptokinase
- Urokinase
Intraoperative Course:
- CPB time (over 150 min increases risk)
- Administration of blood products
- Transfusion of “pump blood” or autologous blood (heparinized blood)
- Administration of antifibrinolytics, DDAVP, or serine protease inhibitor
- Surgical bleeding sites intraoperative
- Presence of microvascular bleeding at sternal closure
