Retained Blood Syndrome Is Associated With High Mortality and Morbidity After Cardiac Surgery
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Authors
Al Saqer,Lean A.
Fox,Louisa Anita
Castells,Ana Maria Soler
Gerontati,Antonia
Bashir,Mohamad
Kumar,Niraj S.
Awad,Wael I.
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2025
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Article
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Background Bleeding into mediastinal and pleural cavities is common after cardiac surgery. Retained blood syndrome (RBS) refers to the need for further interventions to remove blood, blood clot, or bloody fluid from around the heart and lungs. The aim of this study was to ascertain the incidence of RBS following cardiac surgery at our center and evaluate ensuing outcomes. Methods We conducted a retrospective analysis of all patients who underwent cardiac surgery between September 2017 and February 2018, with follow-up completed in February 2022. The primary endpoint was the incidence of RBS secondary endpoints including postoperative survival at 30 days, 6 months, and 5 years, incidence of postoperative atrial fibrillation (POAF), acute kidney injury (AKI), surgical site infection (SSI), and prolonged length of stay in intensive therapy unit (ITU) (> 72 h) and hospital (> 10 days). Results A total of 1002 patients underwent surgery during the study period, of whom 12.7% (127/1002) developed RBS. Mortality was higher among RBS patients compared with non-RBS patients at 30 days, 6 months, and 5 years (11.9% vs. 2.5% (p < 0.001), 18.1% vs. 4.2% (p = 0.001), and 19.0% vs, 8.9% (p < 0.001), respectively). The incidence of all secondary endpoints was also higher among RBS patients: POAF (33.9% vs. 20.8%, p < 0.001), AKI (38.6% vs. 17.9%, p < 0.001), SSI (11.8% vs. 2.1%, p < 0.001), prolonged ITU stay (61.4% vs. 31.4%, p < 0.001), and prolonged hospital stay (51.2% vs. 19.7%, p < 0.001). Conclusions The incidence of RBS following cardiac surgery is high and is associated with increased mortality and morbidity. Implementing interventions to minimize bleeding and reduce retained blood volume postcardiac surgery may improve patient outcomes.
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Journal of cardiac surgery
Volume
2025