Predictive models for prolonged hospitalization following major hemorrhage: a retrospective study

Objective This retrospective study aimed to identify the perioperative risk factors associated with prolonged hospital stays in patients undergoing hemostatic resuscitation for intraoperative massive bleeding. Methods The retrospective analysis included clinical data from 119 patients who received intraoperative resuscitation for intraoperative massive hemorrhage. Patients were divided into two groups based on length of hospital stay, using the 3rd quartile as the cutoff (> 26 days vs. ≤ 26 days). The Mann–Whitney U test or independent samples t-test analyzed the influence of categorical variables on hospital stay. Chi-square test was used for count data, and continuous variables were analyzed using Spearman correlation. Risk factors prolonging hospitalization were identified and predictive models developed. Results Multivariate analysis revealed that independent risk factors for prolonged hospitalization following major hemorrhage comprised unplanned reoperation (OR = 6.743, P = 0.008), admission to the intensive care unit (ICU) (OR = 9.294, P = 0.020), impaired renal function (OR = 11.554, P < 0.001), Postoperative pulmonary inflammation (OR = 4.696, P = 0.018) and body mass index (BMI) (OR = 10.030, P = 0.046). The area under the receiver operating characteristic curve (AUC) of the constructed predictive model was 0.908. Conclusion Our study identified potentially risk factors, like BMI and abnormal kidney function, prolonging hospitalization after intraoperative massive hemorrhage. The predictive model may aid in identifying high-risk patients needing aggressive management to minimize complications. However, it is imperative to conduct prospective, high-quality research in order to validate our findings in the future.