Bleeding Independently associated with Mortality after noncardiac Surgery (BIMS): an international prospective cohort study establishing diagnostic criteria and prognostic importance.

Aged Cohort Studies Female Humans Male Middle Aged Postoperative Hemorrhage / diagnosis Prognosis Prospective Studies
anaemia mortality noncardiac surgery perioperative bleeding postoperative outcome transfusion

Journal

British journal of anaesthesia
ISSN: 1471-6771
Titre abrégé: Br J Anaesth
Pays: England
ID NLM: 0372541

Informations de publication

Date de publication:
01 2021
Historique:
received: 27 04 2019
revised: 25 05 2020
accepted: 23 06 2020
pubmed: 10 8 2020
medline: 29 1 2021
entrez: 10 8 2020
Statut: ppublish

Résumé

We aimed to establish diagnostic criteria for bleeding independently associated with mortality after noncardiac surgery (BIMS) defined as bleeding during or within 30 days after noncardiac surgery that is independently associated with mortality within 30 days of surgery, and to estimate the proportion of 30-day postoperative mortality potentially attributable to BIMS. This was a prospective cohort study of participants ≥45 yr old having inpatient noncardiac surgery at 12 academic hospitals in eight countries between 2007 and 2011. Cox proportional hazards models evaluated the adjusted relationship between candidate diagnostic criteria for BIMS and all-cause mortality within 30 days of surgery. Of 16 079 participants, 2.0% (315) died and 36.1% (5810) met predefined screening criteria for bleeding. Based on independent association with 30-day mortality, BIMS was identified as bleeding leading to a postoperative haemoglobin <70 g L Bleeding independently associated with mortality after noncardiac surgery (BIMS), defined as bleeding that leads to a postoperative haemoglobin <70 g L NCT00512109.

Sections du résumé

BACKGROUND
We aimed to establish diagnostic criteria for bleeding independently associated with mortality after noncardiac surgery (BIMS) defined as bleeding during or within 30 days after noncardiac surgery that is independently associated with mortality within 30 days of surgery, and to estimate the proportion of 30-day postoperative mortality potentially attributable to BIMS.
METHODS
This was a prospective cohort study of participants ≥45 yr old having inpatient noncardiac surgery at 12 academic hospitals in eight countries between 2007 and 2011. Cox proportional hazards models evaluated the adjusted relationship between candidate diagnostic criteria for BIMS and all-cause mortality within 30 days of surgery.
RESULTS
Of 16 079 participants, 2.0% (315) died and 36.1% (5810) met predefined screening criteria for bleeding. Based on independent association with 30-day mortality, BIMS was identified as bleeding leading to a postoperative haemoglobin <70 g L
CONCLUSIONS
Bleeding independently associated with mortality after noncardiac surgery (BIMS), defined as bleeding that leads to a postoperative haemoglobin <70 g L
CLINICAL TRIAL REGISTRATION
NCT00512109.

Identifiants

DOI: 10.1016/j.bja.2020.06.051 PMID: 32768179
pubmed: 32768179
pii: S0007-0912(20)30536-5
doi: 10.1016/j.bja.2020.06.051
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT00512109']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

163-171

Commentaires et corrections

Type : CommentIn
Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2020 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

Auteurs

Pavel S Roshanov (PS)

Division of Nephrology, London Health Science Centre, London, ON, Canada. Electronic address: pavel.roshanov@lhsc.on.ca.

John W Eikelboom (JW)

Department of Medicine, McMaster University, Hamilton, ON, Canada; Population Health Research Institute, Hamilton, ON, Canada.

Daniel I Sessler (DI)

Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA.

Clive Kearon (C)

Department of Medicine, McMaster University, Hamilton, ON, Canada; Thrombosis and Atherosclerosis Research Institute, Canada.

Gordon H Guyatt (GH)

Department of Medicine, McMaster University, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact, Canada.

Mark Crowther (M)

Department of Medicine, McMaster University, Hamilton, ON, Canada.

Vikas Tandon (V)

Department of Medicine, McMaster University, Hamilton, ON, Canada.

Flavia Kessler Borges (FK)

Department of Medicine, McMaster University, Hamilton, ON, Canada; Population Health Research Institute, Hamilton, ON, Canada.

Andre Lamy (A)

Department of Health Research Methods, Evidence, and Impact, Canada; Department of Surgery, McMaster University, Hamilton, ON, Canada.

Richard Whitlock (R)

Population Health Research Institute, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact, Canada; Department of Surgery, McMaster University, Hamilton, ON, Canada.

Bruce M Biccard (BM)

Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, Observatory, Cape Town, Western Cape, South Africa; University of Cape Town, Rondebosch, Cape Town, Western Cape, South Africa.

Wojciech Szczeklik (W)

Department of Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Krakow, Poland.

Mohamed Panju (M)

Department of Medicine, McMaster University, Hamilton, ON, Canada.

Jessica Spence (J)

Population Health Research Institute, Hamilton, ON, Canada.

Amit X Garg (AX)

Division of Nephrology, London Health Science Centre, London, ON, Canada; Institute for Clinical Evaluative Sciences at Western, London, ON, Canada.

Michael McGillion (M)

Population Health Research Institute, Hamilton, ON, Canada; School of Nursing, Faculty of Health Sciences, Canada.

Tomas VanHelder (T)

Department of Anesthesia, Canada.

Peter A Kavsak (PA)

Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada.

Justin de Beer (J)

Department of Surgery, McMaster University, Hamilton, ON, Canada.

Mitchell Winemaker (M)

Department of Surgery, McMaster University, Hamilton, ON, Canada.

Yannick Le Manach (Y)

Population Health Research Institute, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact, Canada; Department of Anesthesia, Canada.

Tej Sheth (T)

Department of Medicine, McMaster University, Hamilton, ON, Canada.

Jehonathan H Pinthus (JH)

Department of Surgery, McMaster University, Hamilton, ON, Canada.

Deborah Siegal (D)

Department of Medicine, McMaster University, Hamilton, ON, Canada.

Lehana Thabane (L)

Population Health Research Institute, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact, Canada; Biostatistics Unit, St Joseph's Healthcare, Hamilton, ON, Canada.

Marko R I Simunovic (MRI)

Department of Health Research Methods, Evidence, and Impact, Canada; Department of Surgery, McMaster University, Hamilton, ON, Canada.

Ryszard Mizera (R)

Department of Medicine, McMaster University, Hamilton, ON, Canada.

Sebastian Ribas (S)

Department of Medicine, McMaster University, Hamilton, ON, Canada.

Philip J Devereaux (PJ)

Department of Medicine, McMaster University, Hamilton, ON, Canada; Population Health Research Institute, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact, Canada.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Bleeding Independently associated with...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Bleeding Independently associated with...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Bleeding Independently associated with...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Bleeding Independently associated with...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Complications postopératoires › Hémorragie postopératoire › Bleeding Independently associated with...
questionsmedicales.fr › Diagnostic › Pronostic › Bleeding Independently associated with...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études prospectives › Bleeding Independently associated with...