Objective Identification of the risk factors for extraordinary hidden blood loss(HBL) could clarify the underlying causes and provide more appropriate management. This study aims to identify the predictors of HBL in s...Objective Identification of the risk factors for extraordinary hidden blood loss(HBL) could clarify the underlying causes and provide more appropriate management. This study aims to identify the predictors of HBL in spinal surgery.Methods Medical records were retrospectively retrieved to collect the data of patients who undergoing posterior thoracic and lumbar fusion surgery or scoliosis surgery. Demographic information, perioperative visible blood loss volume, as well as laboratory results were recorded. The patients receiving fusion surgery or scoliosis surgery were further divided into the HBL positive subgroup and the HBL negative subgroup. Differences in the variables between the groups were then analyzed. Binary logistic regression analysis was performed to determine independent risk factors associated with HBL.Results For patients undergoing posterior spinal surgery, the independent risk factors associated with HBL were autologous transfusion(for fusion surgery P = 0.011, OR: 2.627, 95%CI: 1.574-2.782; for scoliosis surgery P < 0.001, OR: 2.268, 95%CI: 2.143-2.504) and allogeneic transfusion(for fusion surgery P < 0.001, OR: 6.487, 95%CI: 2.349-17.915; for scoliosis surgery P < 0.001, OR: 3.636, 95%CI: 2.389-5.231).Conclusion Intraoperative blood transfusion might be an early-warning indicator for perioperative HBL.展开更多
目的探讨西藏高海拔地区人群行全身麻醉非心胸外科手术术中低氧血症发生率及其危险因素,并简要分析术中低氧血症对患者预后的影响。方法前瞻性收集2021年6月1日至2022年8月31日西藏自治区人民医院行全身麻醉非心胸外科手术患者的临床资...目的探讨西藏高海拔地区人群行全身麻醉非心胸外科手术术中低氧血症发生率及其危险因素,并简要分析术中低氧血症对患者预后的影响。方法前瞻性收集2021年6月1日至2022年8月31日西藏自治区人民医院行全身麻醉非心胸外科手术患者的临床资料,包括术前基本资料、手术及麻醉相关信息,主要结局指标为术中低氧血症。采用多因素Logistic回归法分析术中低氧血症的危险因素,并比较术中低氧血症与非术中低氧血症患者围术期预后指标差异。结果共入选符合纳入与排除标准的全身麻醉非心胸外科手术患者161例。其中发生术中低氧血症9例(5.6%),非术中低氧血症152例(94.4%)。多因素Logistic回归分析结果显示,术前血氧饱和度≤85%(OR=4.604,95%CI:1.064~19.916,P=0.041)、术前血红蛋白≥170 g/L(OR=5.396,95%CI:1.163~25.035,P=0.031)、术前肺动脉压≥40 mm Hg(OR=11.744,95%CI:1.599~86.243,P=0.015)是西藏高海拔地区人群行全身麻醉非心胸外科手术出现术中低氧血症的独立危险因素。术中低氧血症患者围术期心脏不良事件发生率较非术中低氧血症患者显著增加(55.6%比15.1%,P=0.002)。结论术前低血氧饱和度、高血红蛋白血症和肺动脉高压是西藏高海拔地区人群行全身麻醉非心胸外科手术术中低氧血症的危险因素,且术中低氧血症可能对患者预后造成不良影响。展开更多
文摘Objective Identification of the risk factors for extraordinary hidden blood loss(HBL) could clarify the underlying causes and provide more appropriate management. This study aims to identify the predictors of HBL in spinal surgery.Methods Medical records were retrospectively retrieved to collect the data of patients who undergoing posterior thoracic and lumbar fusion surgery or scoliosis surgery. Demographic information, perioperative visible blood loss volume, as well as laboratory results were recorded. The patients receiving fusion surgery or scoliosis surgery were further divided into the HBL positive subgroup and the HBL negative subgroup. Differences in the variables between the groups were then analyzed. Binary logistic regression analysis was performed to determine independent risk factors associated with HBL.Results For patients undergoing posterior spinal surgery, the independent risk factors associated with HBL were autologous transfusion(for fusion surgery P = 0.011, OR: 2.627, 95%CI: 1.574-2.782; for scoliosis surgery P < 0.001, OR: 2.268, 95%CI: 2.143-2.504) and allogeneic transfusion(for fusion surgery P < 0.001, OR: 6.487, 95%CI: 2.349-17.915; for scoliosis surgery P < 0.001, OR: 3.636, 95%CI: 2.389-5.231).Conclusion Intraoperative blood transfusion might be an early-warning indicator for perioperative HBL.
文摘目的探讨西藏高海拔地区人群行全身麻醉非心胸外科手术术中低氧血症发生率及其危险因素,并简要分析术中低氧血症对患者预后的影响。方法前瞻性收集2021年6月1日至2022年8月31日西藏自治区人民医院行全身麻醉非心胸外科手术患者的临床资料,包括术前基本资料、手术及麻醉相关信息,主要结局指标为术中低氧血症。采用多因素Logistic回归法分析术中低氧血症的危险因素,并比较术中低氧血症与非术中低氧血症患者围术期预后指标差异。结果共入选符合纳入与排除标准的全身麻醉非心胸外科手术患者161例。其中发生术中低氧血症9例(5.6%),非术中低氧血症152例(94.4%)。多因素Logistic回归分析结果显示,术前血氧饱和度≤85%(OR=4.604,95%CI:1.064~19.916,P=0.041)、术前血红蛋白≥170 g/L(OR=5.396,95%CI:1.163~25.035,P=0.031)、术前肺动脉压≥40 mm Hg(OR=11.744,95%CI:1.599~86.243,P=0.015)是西藏高海拔地区人群行全身麻醉非心胸外科手术出现术中低氧血症的独立危险因素。术中低氧血症患者围术期心脏不良事件发生率较非术中低氧血症患者显著增加(55.6%比15.1%,P=0.002)。结论术前低血氧饱和度、高血红蛋白血症和肺动脉高压是西藏高海拔地区人群行全身麻醉非心胸外科手术术中低氧血症的危险因素,且术中低氧血症可能对患者预后造成不良影响。
