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Phenotype submission - Postoperative hemorrhage

Cohort Definition Name: Postoperative hemorrhage
Contributor name: Andreas Weinberger Rosen
Contributor OrcId: 0000-0001-9990-8155
Logic Description: First event postoperative hemorrhage
Recommended study application: exposure, outcome, indication.
Assertion statement: This cohort definition was executed on at least one real person-level observational health data source and resulted in a cohort with at least 1 person.
Submitted cohort definition:
Postoperative hemorrhage.txt (1.2 KB)

Target Clinical Description

Postoperative hemorrhage is the excessive loss of blood following a surgical procedure, either from the surgical site or from another source within the body. This complication can arise immediately after surgery or within the postoperative period. It is a critical and potentially life-threatening event that requires prompt diagnosis and intervention to prevent shock, organ failure, or death.
Presentation of Postoperative Hemorrhage

Common presentations for postoperative hemorrhage include:

  • Sudden drop in blood pressure
  • Increased heart rate and palpitations
  • Pallor and cold, clammy skin
  • Decreased urine output
  • Confusion or altered mental status
  • Rapid swelling or increased pain at the surgical site
  • Unexplained drop in hemoglobin or hematocrit levels

Assessment for Postoperative Hemorrhage

  • Immediate vital signs and continuous monitoring
  • Blood tests, including complete blood count and coagulation studies
  • Quick assessment of the surgical site for external bleeding
  • Imaging studies, such as ultrasound or CT scan, to identify internal bleeding
  • Consultation with surgical team for possible reoperation

Differential Diagnosis of Postoperative Hemorrhage

  • Hematoma formation
  • Coagulation disorders
  • Drug-induced bleeding (e.g., anticoagulants)
  • Non-surgical bleeding sources (e.g., gastrointestinal tract)
  • Vasovagal reaction or orthostatic hypotension

Treatment Plan for Postoperative Hemorrhage

Immediate interventions often include hemodynamic stabilization with intravenous fluids and blood transfusions, as well as measures to control the source of bleeding. This could involve direct pressure, electrocautery, or surgical re-exploration and repair. Hemostatic agents may also be employed, and correction of coagulopathy might be necessary.
Prognosis for Postoperative Hemorrhage

The prognosis for postoperative hemorrhage largely depends on the speed of diagnosis and effectiveness of intervention. Rapid recognition and treatment can lead to a more favorable outcome. However, delayed management or severe bleeding can result in complications such as hypovolemic shock, multi-organ failure, or death. The patient’s overall health status, type of surgery, and any existing coagulation disorders can also significantly impact the prognosis.

Assignment for Peer Review:

Peer review of the phenotype would be more than welcome

Imported to the OHDSI Phenotype Library. It may be expected to be found with id = 808 in the next release. Thank you