Is it possible to predict postoperative blood loss in surgery for idiopathic scoliosis?

Abstract

Introduction: Postoperative drain loss can exceed intraoperative blood loss and affect the severity of the patient’s condition. Aim: The objective of the study was to find significant predictors of postoperative blood loss in surgery for idiopathic scoliosis.Materials and methods: We analyzed the data of 140 patients with idiopathic scoliosis. One hundred three patients (group 1) un-derwent Smith-Petersen osteotomy as part of the multilevel pedicle screw fixation; 37 patients (group 2) required no spinal osteotomy. Correlation and regression analysis of the data was performed.Results: There were significant differences between the groups in the number of fixed segments (p<0.001), the volume of intraoperative blood loss (p<0.001), drain loss (p=0.010), and perioperative blood loss (p<0.001). The study showed that spinal osteotomy had no effect on the volume of postoperative blood loss. A univariate regression analysis revealed the following predictors: patient’s body weight −0.3 [−0.4; −0.2] (p<0.001) and intraoperative blood loss expressed as a percentage of circulating blood volume 0.3 [0.2; 0.5] (p<0.001). The predictors established in univariate regression analysis were significant also in the multivariate analysis. Conclusions: The study established the most significant predictors determining the volume of postoperative blood loss in surgery for idiopathic scoliosis: body weight and intraoperative blood loss expressed in percentages of circulating blood volume. A model for pre-dicting the volume of postoperative blood loss was created based on the identified parameters. This model will optimize support for the treatment associated with transfusion during the perioperative period.

Keywords

• blood loss predictors
• pedicle screw fixation
• spi