Efficacy of a problem, intervention, control, and outcomes (PICO)-based perioperative blood management plan developed for patients undergoing long-segment lumbar spine posterior surgery.

Background: This study aimed to develop and evaluate the effectiveness of a perioperative blood management plan based on the problem, intervention, control, and outcomes (PICO) model for long-segment lumbar spine posterior surgery.

Methods: In this retrospective study, 51 patients who needed long-segment posterior lumbar spine surgery at the Second Affiliated Hospital of Nantong University Department of Spinal Surgery from July 2020 to June 2022 were included in the control group, while 51 patients who needed long-segment posterior lumbar spine surgery from July 2021 to June 2022 were selected as the observation group. Patients in the control group received conventional blood management, while those in the observation group were additionally administered an evidence-based perioperative blood management plan. We compared the intervention outcomes in both the groups.

Results: Patients in the observation group demonstrated significantly higher postoperative hemoglobin levels and hematocrit at various time points compared to those in the control group (P < 0.05). Intraoperative blood loss, postoperative drainage volume, and average volume of allogeneic blood transfused per recipient, as well as the number and frequency of allogeneic blood transfusions, were significantly lower in the observation group (P < 0.05). The duration of surgical drain placement and postoperative hospital stay were notably shorter in the observation group (P < 0.05). The two groups did not differ significantly in the incidence of postoperative venous thromboembolism (VTE) (P > 0.05).

Conclusion: The implementation of a perioperative blood management plan was effective in reducing the total blood loss and transfusion volume in the perioperative period, improving hemoglobin and hematocrit levels, facilitating earlier removal of surgical drains, and accelerating patient discharge.