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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(06): e905-e911
DOI: 10.1055/s-0043-1775887
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Blood Loss Control in Patients with Idiopathic Scoliosis Undergoing Spinal Fusion: Prospective Evaluation of a Cohort[*]

Article in several languages: português | English
Sebastião Vieira de Morais 
1   Chefe do Serviço de Ortopedia e Traumatologia do Hospital Universitário Presidente Dutra, Universidade Federal do Maranhão, São Luís, Brasil
,
Anderson Matheus Medeiros de Araújo 
2   Médico Residente de Ortopedia e Traumatologia do Hospital Universitário Presidente Dutra, Universidade Federal do Maranhão, São Luís, Brasil
,
Camila Costa Lacerda de Sousa 
3   Acadêmica de medicina da Universidade UNICEUMA – Centro Universitário do Maranhão, São Luís, Brasil
› Author Affiliations

Financial Support This study received no financial support from public, commercial, or not-for-profit sources.
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Abstract

Objective This study aimed to identify risk factors for increased perioperative bleeding in scoliosis surgery.

Methods This is a prospective cohort study including 30 patients with idiopathic scoliosis undergoing posterior instrumentation using the pedicle screw system at a university hospital.

Results Intraoperative blood losses totaled 798.6 ± 340 mL (24.8% of blood volume). Nine subjects presented massive blood loss. On average, hemoglobin dropped by 3.7 g/dL, and each patient received 1.4 blood bags. Postoperative blood loss was 693.4 ± 331.1 mL, and the total number of days using a drain was 2.7 ± 0.7. Intraoperatively, the following variables showed significant correlations (p < 0.05) with increased bleeding: age, time from diagnosis to treatment, preoperative Cobb angle, amount of curve correction, number of instrumented and fixated levels, total number of screws, and the number of transfused bags. Postoperatively, the following variables had significant correlations (p < 0.05): age, preoperative Cobb angle, length of hospital stay, number of blood bags transfused, and number of levels fixated with screws.

Conclusion The variables most contributing to blood loss were age, preoperative Cobb angle, number of blood bags transfused, and number of levels fixated with a screw. Therefore, patients may benefit from surgical treatment while younger and presenting a lower Cobb angle, consequently requiring a lower degree of curve correction and lower-density implants.

Keywords

scoliosis - spinal fusion - hemorrhage - blood loss, surgical

* Study developed at the Orthopedics and Traumatology Service, Hospital Universitário Presidente Dutra, Universidade Federal do Maranhão, São Luís, Brazil.




Publication History

Received: 06 January 2023

Accepted: 27 February 2023

Article published online:
08 December 2023

© 2023. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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