With proper care and planning, people with bleeding disorders can undergo major surgery and fare about as well as the general population, according to new research.
The study, published in March in the journal Clinical and Applied Thrombosis/Hemostasis, followed 50 patients with bleeding disorders — 29 women and 21 men — after 63 surgeries. They assessed how many had unanticipated bleeding following the operation, how long they stayed in the hospital, whether they were readmitted and whether anyone needed additional measures to stop bleeding. The researchers compared these 50 patients to data about general population patients from the National Surgical Quality Improvement Program.
The researchers found that patients with bleeding disorders had episodes of major bleeding around 5% of the time, compared to 1.6 % for the control patients who didn’t have bleeding disorders. That’s far better than a few decades ago before innovations in treatments. Before 1966, people with hemophilia A undergoing major surgeries faced a mortality rate as high as 60%, the researchers wrote. By the 1980s, it dropped to 3-5%.
The researchers looked at surgeries from 2017-2019 and found that 59 of the 63 saw no bleeding complications. Of the four that did have unexpected bleeding, three were considered major bleeding, meaning they needed transfusions of red blood cells. Five patients needed unplanned hemostatic therapy, and 1.6% of the patients were readmitted to a hospital within 30 days.
The authors, who are researchers at Thomas Jefferson University in Philadelphia, Pennsylvania, believe their study is the largest analysis of its kind.