The operating surgeon is an independent predictor of chest tube drainage following cardiac surgery.
OBJECTIVE
Bleeding into the chest is a major cause of blood transfusion and adverse outcomes following cardiac surgery. The authors investigated predictors of bleeding following cardiac surgery to identify potentially correctable factors.


METHODS
Data were retrieved from the medical records of patients undergoing cardiac surgery over the period of 2002 to 2008. Multivariate analysis was used to identify the independent predictors of chest tube drainage.


METHODS
Tertiary hospital.


METHODS
Two thousand five hundred seventy-five patients.


METHODS
Cardiac surgery.


RESULTS
The individual operating surgeon was independently associated with the extent of chest tube drainage. Other independent factors included internal mammary artery grafting, cardiopulmonary bypass time, urgency of surgery, tricuspid valve surgery, redo surgery, left ventricular impairment, male gender, lower body mass index and higher preoperative hemoglobin levels. Both a history of diabetes and administration of aprotinin were associated with reduced levels of chest tube drainage.


CONCLUSIONS
The individual operating surgeon was an independent predictor of the extent of chest tube drainage. Attention to surgeon-specific factors offers the possibility of reduced bleeding, fewer transfusions, and improved patient outcomes.
Department of Intensive Care, St. Vincent's Hospital, Melbourne, Australia. Electronic address: barry.dixon@svhm.org.au.
Barry
B
Dixon
Department of Intensive Care, St. Vincent's Hospital, Melbourne, Australia.
David
D
Reid
Department of Statistics, Peter MacCallum Hospital, Melbourne, Australia.
Marnie
M
Collins
Department of Cardiothoracic Surgery, St. Vincent's Hospital, Melbourne, Australia.
Andrew E
AE
Newcomb
Department of Cardiothoracic Surgery, St. Vincent's Hospital, Melbourne, Australia.
Alexander
A
Rosalion
Department of Cardiothoracic Surgery, Geelong Hospital, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
Cheng-Hon
CH
Yap
Department of Intensive Care, St. Vincent's Hospital, Melbourne, Australia.
John D
JD
Santamaria
St. Vincent's Institute of Medical Research, St. Vincent's Hospital, Melbourne, Australia; Department of Medicine, University of Melbourne, St. Vincent's Hospital, Melbourne, Australia.
Duncan J
DJ
Campbell
D000368:Aged; D000369:Aged, 80 and over; D000933:Antifibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use; D007611:Aprotinin / Q000009:adverse effects; D015992:Body Mass Index; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002315:Cardiopulmonary Bypass; D015505:Chest Tubes / Q000706:statistics & numerical data*; D004322:Drainage / Q000706:statistics & numerical data*; D005260:Female; D006454:Hemoglobins / Q000032:analysis / Q000378:metabolism; D006490:Hemostatics / Q000009:adverse effects; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation; D008875:Middle Aged; D015999:Multivariate Analysis; D010820:Physicians; D019106:Postoperative Hemorrhage / Q000453:epidemiology* / Q000628:therapy; D017534:Radial Artery / Q000637:transplantation; D012086:Reoperation / Q000706:statistics & numerical data; D012737:Sex Factors; D014261:Tricuspid Valve / Q000601:surgery; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology
D000933:Antifibrinolytic Agents; D006454:Hemoglobins; D006490:Hemostatics; D007611:Aprotinin
bleeding; blood transfusion; cardiac surgery; chest tube; surgeon