Chinese Medical Sciences Journal ›› 2019, Vol. 34 ›› Issue (1): 38-44.doi: 10.24920/003463

• Original Articles • Previous Articles     Next Articles

Prediction of Hidden Blood Loss During Posterior Spinal Surgery

Bai Bing1, Tian Yuan1, Zhang Yuelun2, Ma Manjiao1, Yu Xuerong1, *(), Huang Yuguang1   

  1. 1 Department of Anesthesiology,Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
    2 Central Research Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
  • Received:2018-05-15 Revised:2019-02-22 Published:2019-03-30 Online:2019-04-08
  • Contact: Yu Xuerong E-mail:yuxuerong@pumch.cn

Objective Identification of the risk factors for extraordinary hidden blood loss (HBL) could clarify the underlying causes and provide more appropriate management. This study aims to identify the predictors of HBL in spinal surgery.

Methods Medical records were retrospectively retrieved to collect the data of patients who undergoing posterior thoracic and lumbar fusion surgery or scoliosis surgery. Demographic information, perioperative visible blood loss volume, as well as laboratory results were recorded. The patients receiving fusion surgery or scoliosis surgery were further divided into the HBL positive subgroup and the HBL negative subgroup. Differences in the variables between the groups were then analyzed. Binary logistic regression analysis was performed to determine independent risk factors associated with HBL.

Results For patients undergoing posterior spinal surgery, the independent risk factors associated with HBL were autologous transfusion (for fusion surgery P=0.011, OR: 2.627, 95%CI: 1.574-2.782; for scoliosis surgery P<0.001, OR: 2.268, 95%CI: 2.143-2.504) and allogeneic transfusion (for fusion surgeryP<0.001, OR:6.487, 95%CI: 2.349-17.915; for scoliosis surgery P<0.001, OR: 3.636, 95%CI: 2.389-5.231).

Conclusion Intraoperative blood transfusion might be an early-warning indicator for perioperative HBL.

Key words: spinal surgery, hidden blood loss, transfusion, prediction

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