The Utility of the Validated Intraoperative Bleeding Scale in Thoracolumbar Spine Surgery: A Single-Center Prospective Study.

Autor:	Smith RA; Division of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, Baltimore, MD, USA., Pease TJ; Division of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, Baltimore, MD, USA., Chiu AK; Division of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, Baltimore, MD, USA., Shear BM; Division of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, Baltimore, MD, USA., Sahlani MN; Division of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, Baltimore, MD, USA., Ratanpal AS; Division of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, Baltimore, MD, USA., Ye IB; Division of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, Baltimore, MD, USA., Thomson AE; Division of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, Baltimore, MD, USA., Bivona LJ; Division of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, Baltimore, MD, USA., Jauregui JJ; Division of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, Baltimore, MD, USA., Crandall KM; Division of Spine Surgery, Department of Neurosurgery, University of Maryland Medical Center, Baltimore, MD, USA., Sansur CA; Division of Spine Surgery, Department of Neurosurgery, University of Maryland Medical Center, Baltimore, MD, USA., Cavanaugh DL; Division of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, Baltimore, MD, USA., Koh EY; Division of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, Baltimore, MD, USA., Ludwig SC; Division of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, Baltimore, MD, USA.
Jazyk:	angličtina
Zdroj:	Global spine journal [Global Spine J] 2024 Jan 24, pp. 21925682241228219. Date of Electronic Publication: 2024 Jan 24.
DOI:	10.1177/21925682241228219
Abstrakt:	Study Design: Prospective, single-center study. Objective: To evaluate the clinical relevance of the validated intraoperative bleeding severity scale (VIBe) in thoracolumbar spine surgery. Methods: Adult patients aged 18 through 88 undergoing elective decompression, instrumentation, and fusion of the thoracolumbar spine were prospectively enrolled after informed consent was provided and written consent was obtained. Validated intraoperative bleeding severity scores were recorded intraoperatively. Univariate analysis consisted of Student T-tests, Pearson's χ 2 Tests, Fisher's Exact Tests, linear regression, and binary logistic regression. Multivariable regression was conducted to adjust for baseline characteristics and potential confounding variables. Results: A total of N = 121 patients were enrolled and included in the analysis. After adjusting for confounders, VIBe scores were correlated with an increased likelihood of intraoperative blood transfusion (β = 2.46, P = .012), postoperative blood transfusion (β = 2.36, P = .015), any transfusion (β = 2.49, P < .001), total transfusion volume (β = 180.8, P = .020), and estimated blood loss (EBL) (β = 409, P < .001). Validated intraoperative bleeding severity scores had no significant association with length of hospital stay, 30-day readmission, 30-day reoperation, 30-day emergency department visit, change in pre- to post-op hemoglobin and hematocrit, total drain output, or length of surgery. Conclusion: The VIBe scale is associated with perioperative transfusion rates and EBL in patients undergoing thoracolumbar spine surgery. Overall, the VIBe scale has clinically relevant meaning in spine surgery, and shows potential utility in clinical research. Level of Evidence: Level II. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: In addition, the following conflicts of interest and funding sources have been declared by the authors below. For the remaining authors none were declared. BS: Maryland Orthopaedic Association: Board or committee member, JJ: Children: Editorial or governing board, KC: Cerapedics: Paid presenter or speaker, Stryker: Paid consultant, CS: Executive Committee of the American Association of Neurosurgery Spine Section: Board or committee member Journal of Neurosurgery: Spine: Editorial or governing board Nuvasive: IP royalties; Paid consultant Stryker: IP royalties, DC: Alphatec Spine: Paid consultant; Stock or stock Options, EK: Alphatec Spine: Stock or stock Options, SL: AAOS: Board or committee member Alphatec Spine: IP royalties; Stock or stock Options American Board of Orthopaedic Surgery, Inc.: Board or committee member American Orthopaedic Association: Board or committee member AO Spine North America Spine Fellowship Support: Research support ASIP, ISD: Stock or stock Options Atlas Spine: IP royalties Baxter: Research support Cervical Spine Research Society: Board or committee member Contemporary Spine Surgery: Editorial or governing board DePuy, A Johnson & Johnson Company: IP royalties LSRS: Board or committee member MDC: Stock or stock Options Nuvasive: IP royalties; Paid consultant; Paid presenter or speaker; Stock or stock Options OMEGA: Research support Smiss: Board or committee member Stryker: IP royalties The Spine Journal: Editorial or governing board.
Databáze:	MEDLINE
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