Bleeding and long-term survival after lung resections: nationwide observational cohort study.
J Thorac Dis
; 16(7): 4409-4416, 2024 Jul 30.
Article
en En
| MEDLINE
| ID: mdl-39144293
ABSTRACT
Background:
Bleeding following lung surgery can lead to reoperation and blood transfusions, potentially impairing outcomes. This study aimed to assess how bleeding complications affect long-term survival and postoperative complications in a nationwide contemporary group of patients undergoing lung resections.Methods:
Adult patients who underwent lung resections, for both malignant and nonmalignant diagnoses, between 2013-2021, were included from the Swedish national registry for thoracic surgery. Patients with bleeding complications, defined as requiring reexploration and/or transfusions, were compared to patients without bleeding complications regarding long-term survival and postoperative complications. We used propensity scores and optimal full matching to account for differences in baseline characteristics between the groups.Results:
The cohort comprised 15,617 adult patients, of which 646 patients (4.1%) had bleeding complications. The unadjusted 90-day mortality was 9.4% vs. 1.0% in the bleeding group vs. no bleeding group, respectively. After matching, the odds ratio (OR) for 90-day mortality in the bleeding group compared with the no bleeding group was 3.66 [95% confidence interval (CI) 2.17-6.17]. Long term overall survival was lower among patients in the bleeding group, adjusted hazard ratio (95% CI) for all-cause mortality was 1.47 (1.29-1.69). Postoperative complications were more common in the bleeding group (OR 3.00, 95% CI 2.38-3.79), including infections (OR 2.80, 95% CI 1.86-4.20). Bleeding complications were more frequent during the first third of the study time period as compared to the last third (P<0.001).Conclusions:
Patients with bleeding complications had reduced long-term survival and higher incidence of postoperative complications. A declining trend in bleeding rates over time was noted.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
J Thorac Dis
Año:
2024
Tipo del documento:
Article
País de afiliación:
Suecia
Pais de publicación:
China