Aim: To investigate the role of bleeding risk scores, personal and family medical history, and previous
bleeding incidents in assessing the impact on the risk of all possible complications, including mortality,
in adult patients following cardiac surgery.
Methods. The search for publications was conducted using the PubMed, Transfusion Evidence Library,
and eLibrary.ru databases, covering the period from 2019 to 2023. Search terms included:
‘bleeding risk assessment scales in adult cardiac surgery’, ‘preoperative anemia in adult cardiac
surgery’, and ‘transfusion of red blood cell-containing components in cardiac surgery adults’. Duplicate
articles were manually excluded. An additional search was performed among the reference
lists of selected publications.
Results. A total of 2,011 publications were found. In the first stage of selection, clinical studies,
meta-analyses, randomized controlled trials, reviews, and regular reviews without language restrictions
were considered based on the content of the abstract. In the second stage, for studies
that passed the initial screening, decisions were made based on an assessment of the full-text
versions, which presented the consequences of preoperative anemia, postoperative bleeding, and
transfusion therapy in adult cardiac surgery patients. Ultimately, 40 publications were included in
the review.
Conclusion. Preoperative bleeding risk assessment is a multimodal, interdisciplinary challenge that
necessitates a patient-centered approach. It should commence at the preparatory stage and involve primary care physicians, cardiologists, surgeons, anesthesiologists, laboratory diagnostic specialists,
and transfusiologists. The cornerstone of this process is the thorough collection of individual
and family medical histories. Obtaining detailed information through patient involvement, utilizing
bleeding risk rating scales, reviewing previous bleeding incidents, and supporting these findings
with laboratory test data represent the most scientific approach to developing an individualized
management plan for patients at risk of bleeding.
Keywords: preparing the patient for surgery, preoperative assessment of the risk of bleeding, transfusion,
blood components
Conflict of interest: The author declares no conflict of interest.