Hidden blood loss and risk factors after percutaneous endoscopic transforaminal lumbar interbody fusion.

IF 1.6 4区医学 Q2 SURGERY

Frontiers in Surgery Pub Date : 2025-01-15 eCollection Date: 2025-01-01 DOI:10.3389/fsurg.2025.1490038

Meng Ge, Fangbing Zhu, Weibin Du, Zhengcong Ye, Zhenfei Xiong, Lukai Zhang, Hua Zhou, Jun Yang

{"title":"Hidden blood loss and risk factors after percutaneous endoscopic transforaminal lumbar interbody fusion.","authors":"Meng Ge, Fangbing Zhu, Weibin Du, Zhengcong Ye, Zhenfei Xiong, Lukai Zhang, Hua Zhou, Jun Yang","doi":"10.3389/fsurg.2025.1490038","DOIUrl":null,"url":null,"abstract":"Purpose: In this study, we aimed to assess the occurrence of hidden blood loss (HBL) and its associated risk factors in patients with lumbar degenerative diseases who underwent percutaneous endoscopic transforaminal lumbar interbody fusion (Endo-TLIF).Methods: Sex, age, height, weight, body mass index, and medical history including hypertension, diabetes, and osteoporosis were recorded. The duration of symptoms, preoperative lumbar subcutaneous fat tissue thickness (measured using midsagittal T2-weighted magnetic resonance imaging), lumbar disc degeneration grade, and other basic patient information were also documented. The levels of fibrinogen, activated partial thromboplastin time, prothrombin time, thrombin time, and platelet count as well as the pre- and postoperative hematocrit and hemoglobin levels were collected. In addition, the number of fusion levels, surgical time, and intraoperative blood loss were recorded. Total blood loss (TBL) was calculated using the gross formula, and HBL was calculated based on the TBL and visible blood loss. The risk factors were analyzed using single-factor correlation and multivariate linear regression analyses.Results: Of the 83 patients, there were 42 males and 41 females. Hypertension (P = 0.003), fusion level (P < 0.001), and surgery time (P < 0.001) were significantly correlated with HBL via a single-factor correlation analysis. Multiple linear regression analysis showed that the fusion level (P < 0.001) and surgery time (P < 0.001) were independent risk factors for HBL.Conclusion: In patients with lumbar degenerative diseases treated with Endo-TLIF, HBL accounts for a large proportion of TBL. A large number of fusion segments and prolonged operation time are risk factors for increased perioperative HBL during Endo-TLIF. Increased attention should be paid to the presence of HBL to ensure the safety of perioperative patients.","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1490038"},"PeriodicalIF":1.6000,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774912/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fsurg.2025.1490038","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: In this study, we aimed to assess the occurrence of hidden blood loss (HBL) and its associated risk factors in patients with lumbar degenerative diseases who underwent percutaneous endoscopic transforaminal lumbar interbody fusion (Endo-TLIF).

Methods: Sex, age, height, weight, body mass index, and medical history including hypertension, diabetes, and osteoporosis were recorded. The duration of symptoms, preoperative lumbar subcutaneous fat tissue thickness (measured using midsagittal T2-weighted magnetic resonance imaging), lumbar disc degeneration grade, and other basic patient information were also documented. The levels of fibrinogen, activated partial thromboplastin time, prothrombin time, thrombin time, and platelet count as well as the pre- and postoperative hematocrit and hemoglobin levels were collected. In addition, the number of fusion levels, surgical time, and intraoperative blood loss were recorded. Total blood loss (TBL) was calculated using the gross formula, and HBL was calculated based on the TBL and visible blood loss. The risk factors were analyzed using single-factor correlation and multivariate linear regression analyses.

Results: Of the 83 patients, there were 42 males and 41 females. Hypertension (P = 0.003), fusion level (P < 0.001), and surgery time (P < 0.001) were significantly correlated with HBL via a single-factor correlation analysis. Multiple linear regression analysis showed that the fusion level (P < 0.001) and surgery time (P < 0.001) were independent risk factors for HBL.

Conclusion: In patients with lumbar degenerative diseases treated with Endo-TLIF, HBL accounts for a large proportion of TBL. A large number of fusion segments and prolonged operation time are risk factors for increased perioperative HBL during Endo-TLIF. Increased attention should be paid to the presence of HBL to ensure the safety of perioperative patients.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Frontiers in Surgery Medicine-Surgery

CiteScore

1.90

自引率

11.10%

发文量

1872

审稿时长

12 weeks

期刊介绍： Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.