Risk factors for hidden blood loss in unilateral biportal endoscopic spinal surgery for lumbar degenerative diseases
Objective:To identify the risk factors for hidden blood loss(HBL)in patients with single-segment lumbar degenerative diseases who have undergone unilateral biportal endoscopic(UBE)spinal surgery.Methods:A retrospective analysis was conducted on the clinical data of 81 patients with single-segment lumbar degenerative disease who underwent UBE surgery at Beijing Friendship Hospital,Capital Medical University from November 2020 to December 2022.The demographic data included sex,age,height,weight,body mass index(BMI),medical history,smoking and drinking history.The laboratory examination data included pre-and post-operative hemoglobin(Hb),albumin(Alb),hematocrit(HCT),platelet count,preoperative coagulation function,and preoperative biochemical indicators.Imaging data included the thickness of subcutaneous soft tissue,subcutaneous fat,paraspinal muscle thickness,and the ratio of paraspinal muscle thickness to subcutaneous soft tissue thickness at the target segment.Surgical data included diagnosis,American Society of Anesthesiologists classification,operation duration,surgical segment,discectomy,decompression count,intraoperative blood loss,and first-day postoperative drainage.The total perioperative blood loss and HBL were calculated.Univariate and correlation analyses were performed to explore risk factors for HBL during UBE surgery,and multivariate linear regression analysis was used to further identify the independent risk factors.Results:The total perioperative blood loss was 516.5(453.1,598.8)mL,with a visible blood loss of 58.0(40.1,72.3)mL and a HBL of 342.6(285.6,412.4)mL.Univariate analysis indicated that sex,height,history of hypertension,preoperative Hb,HCT and Alb,triglyceride,total cholesterol,and low-density lipoprotein levels were associated with HBL during UBE surgery.Correlation analysis revealed that discectomy and operation duration were correlated with HBL during UBE surgery(all P<0.05).Multiple linear regression analysis confirmed that the preoperative Alb level,discectomy and operation duration were independent risk factors for HBL during UBE surgery(all P<0.05).Conclusions:UBE surgery for single-segment lumbar degenerative diseases has significant HBL during the perioperative period.Preoperative Alb level,discectomy and operation duration may be independent risk factors for HBL.
万方数据
维普
