Incidence and Predictive Factors of Intraoperative Blood Loss in Spinal Surgery at Vachira Phuket Hospital
Keywords:
Predictive Factor,, Spinal Surgery,, Intraoperative Blood LossAbstract
Introduction: Spinal surgery is a major operation with a high risk of massive intraoperative blood loss. Previous studies showed elderly, female, obese, ASA class > 2, multiple levels of surgery, and longer operating time associated with blood transfusion.
Objectives: To identify the incidence and ascertain factors predicting intraoperative blood loss ≥ 500 ml.
Methods: Retrospectively reviewed anesthetic records of 300 patients who underwent spinal surgery from July 2019 to December 2020. Data collection included patient demographics, comorbid conditions, previous lumbar spine surgery, diagnosis, number of surgical levels, operative time intraoperative blood loss, and blood transfusion. Analysis with Chi-square, t-test, Odds ratio, 95% CI, multivariate logistic regression, and p-value < 0.05 was considered significant.
Results: The incidence of intraoperative blood loss ≥ 500 ml was 26.33%. The factors predicting blood loss were instrumentation (adjusted OR = 7.81, 95% CI = 2.74 - 22.24, p = 0.03), thoracolumbar level compared with cervical level (adjusted OR = 16.82, 95% CI = 2.27 – 124.53, p = 0.009), cervical to upper thoracic compare with cervical level (adjusted OR = 102.5, 95% CI = 7.81-1,344.27, p = 0.001), surgical level > three levels (adjusted OR = 4.03, 95% CI = 2.29 -7.08, p = 0.024) and operative time > 120 minute (adjusted OR = 6.39, 95% CI = 3.27-12.48, p = 0.001).
Conclusions: 1 in 4 patients undergoing spinal surgery found intraoperative blood loss ≥ 500 ml. Risk factors were implemented instrumentation, thoracolumbar surgery, surgical level >3, and operative time >120 minutes. Anesthetic personnel should be concerned with the preoperative evaluation and preparing the optimized blood component for spinal surgery.
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