Surreal illustration of surgical precision versus unpredictable bleeding.

Uncontrolled Surgical Bleeding: Why It Still Happens and What It Costs

Elliot Brynn in Health & Wellness November 2025 • 4 min read.

"Despite advances in hemostats, uncontrolled bleeding during surgery remains a significant problem, leading to higher costs and worse outcomes. Learn what factors contribute and what new solutions are on the horizon."

Surgical bleeding is a common occurrence that surgeons continuously strive to minimize. The stakes are high; excessive bleeding can lead to prolonged hospital stays, increased risk of complications, and, in severe cases, even mortality. While significant advancements have been made in surgical techniques and hemostatic agents—tools used to control bleeding—the challenge of uncontrolled bleeding persists.

A 2015 study published in ClinicoEconomics and Outcomes Research sheds light on the significant clinical and economic impact of uncontrolled surgical bleeding. The study, which retrospectively analyzed data from the Premier Perspectives Database, reveals that uncontrolled bleeding, even with the use of hemostats, remains a prevalent issue across various surgical procedures. This article delves into the key findings of this research, exploring the factors contributing to uncontrolled bleeding, its associated costs, and potential avenues for improvement.

Understanding the complexities of uncontrolled surgical bleeding is crucial for healthcare professionals, patients, and stakeholders alike. By examining the data and insights from this study, we can gain a clearer picture of the challenges and opportunities in optimizing surgical outcomes and resource utilization.

Uncontrolled Bleeding: A Persistent Problem Despite Hemostat Use?

Surreal illustration of surgical precision versus unpredictable bleeding.

The study analyzed hospital discharge data from 2012, focusing on patients who underwent one of eight major surgery types and received hemostats during the procedure. These surgeries included cardiac revascularization, cardiac valve surgery, cholecystectomy, cystectomy, pancreatic surgery, partial hepatic resection, pulmonary surgery, and radical abdominal hysterectomy. The researchers then stratified patients based on whether they experienced major bleeding (defined as uncontrolled bleeding) despite the use of hemostats.

The findings revealed a surprisingly high incidence of uncontrolled bleeding, ranging from 32% to 68% of cases, depending on the specific surgical procedure. This highlights a critical point: current hemostatic agents are not always sufficient to achieve complete hemostasis in all patients.

Blood Product Use: The most common indicator of uncontrolled bleeding was the use of blood products, occurring in approximately 49% of all patients in the study.
Transfusion Rates: A significant proportion of patients with uncontrolled bleeding required transfusions, ranging from 25% to 71%, with some needing platelets (5.8%-32.8%) and coagulation factors (up to 3.2%).
Mortality: Mortality rates were significantly higher in the uncontrolled bleeding cohort across most surgical subgroups, ranging from 1.2% to 7.3%, compared to 0% to 1.2% in the controlled bleeding groups.

These statistics paint a concerning picture. Even with the tools and techniques available, a substantial number of patients continue to experience significant bleeding during surgery, leading to increased morbidity and mortality.

The Path Forward: Innovation and Improved Strategies

The study's conclusion underscores the pressing need for more effective hemostatic agents and strategies to manage surgical bleeding. While existing hemostats play a crucial role, they are not a panacea. Innovation in this area is essential to improve patient outcomes and reduce the economic burden associated with uncontrolled bleeding. Future research should focus on assessing the clinical and economic impact of newer hemostats in real-world settings, particularly in patients at high risk for bleeding complications. By continuing to investigate and implement advanced solutions, the goal of optimizing surgical care and minimizing the impact of uncontrolled bleeding can be realized.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.2147/ceor.s86369, Alternate LINK

Title: Health And Economic Outcomes Associated With Uncontrolled Surgical Bleeding: A Retrospective Analysis Of The Premier Perspectives Database

Subject: Health Policy

Journal: ClinicoEconomics and Outcomes Research

Publisher: Informa UK Limited

Authors: Nicole Ferko, Mitra Corral, Sarah Hollmann, Michael Broder, Eunice Chang

Published: 2015-07-01

Everything You Need To Know

What did the ClinicoEconomics and Outcomes Research study reveal about uncontrolled surgical bleeding despite hemostat use?

A 2015 study in *ClinicoEconomics and Outcomes Research* analyzed hospital discharge data from 2012, revealing that uncontrolled surgical bleeding remains a prevalent issue despite the use of hemostats. The incidence ranged from 32% to 68% across procedures like cardiac revascularization, cardiac valve surgery, cholecystectomy, cystectomy, pancreatic surgery, partial hepatic resection, pulmonary surgery, and radical abdominal hysterectomy. This highlights the need for improved bleeding management strategies.

What are the key clinical consequences and statistics associated with uncontrolled bleeding during surgery, as highlighted in the study?

Uncontrolled bleeding during surgery leads to several negative outcomes. The most common indicator is the use of blood products, with roughly 49% of patients requiring them. Transfusion rates can range from 25% to 71%, sometimes necessitating platelets (5.8%-32.8%) and coagulation factors (up to 3.2%). Most concerning is the increased mortality, ranging from 1.2% to 7.3% in uncontrolled bleeding cases, compared to 0% to 1.2% in controlled cases. These statistics emphasize the clinical significance of effective bleeding control.

What future steps and innovations are recommended by the study to address the problem of uncontrolled surgical bleeding?

The study emphasizes the need for innovation in hemostatic agents and improved strategies for managing surgical bleeding. While existing hemostats are valuable, they aren't always sufficient. Future research should assess newer hemostats' clinical and economic impact, especially for patients at high risk of bleeding complications. Implementing advanced solutions is crucial for optimizing surgical care and minimizing the impact of uncontrolled bleeding.

How did the study define and measure uncontrolled bleeding and what are the indicators that were used to access?

The study stratified patients based on whether they experienced major bleeding (defined as uncontrolled bleeding) despite the use of hemostats. The most common indicator of uncontrolled bleeding was the use of blood products, and a significant proportion of patients with uncontrolled bleeding required transfusions, sometimes needing platelets and coagulation factors. Mortality rates were also significantly higher in the uncontrolled bleeding cohort across most surgical subgroups.

Besides hemostat limitations, what other factors might explain why uncontrolled surgical bleeding still occurs?

Several factors may contribute to the persistence of uncontrolled surgical bleeding, even with the use of hemostatic agents. These include patient-specific factors, the complexity of the surgical procedure, and limitations in the effectiveness of current hemostatic agents. The study highlights the need for more effective hemostatic agents and strategies to manage surgical bleeding, as existing hemostats are not always sufficient to achieve complete hemostasis in all patients.