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首页> 外文期刊>Current opinion in anaesthesiology >Preoperative identification of patients with increased risk for perioperative bleeding
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Preoperative identification of patients with increased risk for perioperative bleeding

机译：术前确定围手术期出血风险增加的患者

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PURPOSE OF REVIEW: Although the overall complication rate in cardiac surgery has been decreased, perioperative bleeding increasing morbidity and mortality is still frequent. Furthermore, the widespread use of new antithrombotic and antiplatelet agents presents an additional challenge in daily practice. Therefore, identifying patients with increased bleeding risk would be advantageous to optimize perioperative management. RECENT FINDINGS: Bleeding classifications are frequently discussed, but are of little relevance for the perioperative setting. In the nonsurgical setting the most relevant risk factors in bleeding prediction are age, renal disease, sex, pre-existing anemia, and the administration of antithrombotic/antiplatelet drugs. In cardiac surgery, the Papworth Bleeding Risk Stratification Score identifies mainly procedure-linked risk factors and might be one of the most suitable scores to be used. Routine laboratory screening appears to have limited utility. SUMMARY: Apart from precise bleeding history only insufficient data exist in cardiac surgery to exactly predict bleeding complications. Therefore, there is urgent need for further studies to improve perioperative bleeding management.
机译：审查目的：尽管心脏手术的总体并发症发生率有所降低，但围手术期出血仍增加发病率和死亡率。此外，新的抗血栓形成剂和抗血小板剂的广泛使用在日常实践中提出了另外的挑战。因此，确定出血风险增加的患者将有利于优化围手术期管理。最近的发现：出血分类经常被讨论，但与围手术期设置无关。在非手术环境中，出血预测中最相关的危险因素是年龄，肾脏疾病，性别，既往贫血以及抗血栓/抗血小板药物的给药。在心脏手术中，Papworth出血风险分层评分主要确定与手术相关的危险因素，并且可能是最适合使用的评分之一。常规实验室筛查似乎用途有限。摘要：除了精确的出血史外，心脏手术中仅有不足的数据可以准确预测出血并发症。因此，迫切需要进一步研究以改善围手术期的出血管理。

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