Perioperative consideration in management of severely bleeding coagulopathic patient

Abstract

Background: Perioperative bleeding in severely coagulopathic patients poses significant challenges in clinical management and impacts patient outcomes. Tailored perioperative strategies are essential for optimizing care in this complex cohort.
Objective: This clinical study aimed to investigate the correlation between preoperative coagulation profiles, surgical interventions, and bleeding outcomes in severely bleeding coagulopathic patients within a tertiary care center.
Methods: A retrospective analysis was conducted on 73 severely bleeding coagulopathic patients admitted to the center between 2020-2023. Data collection included demographic characteristics, preoperative coagulation profiles, details of surgical interventions, and postoperative outcomes. Statistical analyses were performed to assess the relationship between preoperative parameters, surgical procedures, and bleeding outcomes.
Results: Preoperative coagulation profiles, including prolonged PT, aPTT, elevated INR, and decreased platelet counts, correlated significantly with the severity of perioperative bleeding. Different surgical procedures exhibited varying extents of bleeding, with orthopedic and abdominal surgeries associated with higher bleeding tendencies. Postoperative complications, such as surgical site hematomas and DIC, were prevalent in cases of severe bleeding.
Conclusion: Tailored perioperative management strategies, informed by preoperative risk assessments and context-specific interventions, are crucial in mitigating bleeding risks and optimizing outcomes in severely bleeding coagulopathic patients. These findings emphasize the need for comprehensive strategies in managing this challenging clinical scenario.