The incidence of postoperative hemorrhage and hematoma with surgical drainage or evacuation in the United States from 2000 to 2012

Abstract

The incidence of postoperative hemorrhage and hematoma with surgical drainage or evacuation in theUnited States from2000 to 2012 Amanda Shakal, Travis Wilson, Ali Seifi University of Texas Health Science Center at San Antonio, USA Background/Purpose: Postoperative hemorrhage is a major risk factor for all surgical procedures and is the cause of significant morbidity and mortality for surgical patients. The purpose of this study is to report the incidence and assess the impact of teaching institutions and sex in this condition. Methods: A retrospective cohort of hospital inpatient discharges with postoperative hemorrhage based on Healthcare Cost and Utilization Project (HCUP) database from 2000 to 2012 in the United States. Results:During the 13-year studyperiod, HCUP reported the incidence of postoperative hemorrhage varying from 2.381 to 2.668 per 1000 surgical admissions, which was significantly less at the end of the study period (P b .000). When assessing the impact of teaching institutions, adjusted rates were significantly higher among teaching institutions duringmost of the study period (P b .000). Furthermore, the adjusted rate was significantly higher in males during all years of the study (P b .000). Conclusions: Our data indicate that the risk of postoperative hemorrhage is higher in patients undergoing surgical procedures at teaching institutions for most of the study years, which could be the result of several factors. Teaching institutions tend to be level 1 trauma centers with unstable patients undergoing emergency surgeries, which may carry significant risk of morbidity and mortality. We also reported a higher rate of postoperative hemorrhage in males, which may be due to larger numbers of injury-related visits to emergency departments and more surgical procedures per year. Additional prospective studies should be undertaken to determine the cause and contributing factors that impact postoperative hemorrhage.