Smaller body size increases the percentage of blood volume lost during posterior spinal arthrodesis

Amit Jain, Paul David Sponseller, Peter O. Newton, Suken A. Shah, Patrick J. Cahill, Dolores B Njoku, Randal R. Betz, Amer F. Samdani, Tracey P. Bastrom, Michelle C. Marks

Research output: Contribution to journalArticle

Abstract

Background: Our goal was to analyze the relationship between patient size and the proportion of blood volume lost during spinal arthrodesis in patients with a diagnosis of adolescent idiopathic scoliosis, Scheuermann kyphosis, or cerebral palsy. We hypothesized that smaller patients (those with less blood volume) lose a greater proportion of circulating total blood volume during surgery. Methods: We reviewed a large, multicenter database, identifying patients with adolescent idiopathic scoliosis (1832), Scheuermann kyphosis (106), or cerebral palsy (196) who had undergone posterior spinal arthrodesis for spinal deformity. Blood volume (estimated from body weight) was used as a measure of patient size. Our primary outcome was the proportion of total circulating blood volume lost (intraoperative blood loss/blood volume, expressed as a percentage). Results: On multivariate analysis, there was a negative relationship between intraoperative blood loss/blood volume and blood volume in patients with adolescent idiopathic scoliosis (coefficient, -5.8; p <0.001), Scheuermann kyphosis (coefficient, -2.5; p <0.001), or cerebral palsy (coefficient, -20.3; p <0.001), indicating that, despite adjustment for all other factors, smaller patients lost a greater proportion of their blood volume. In patients with adolescent idiopathic scoliosis or Scheuermann kyphosis, multivariate analysis showed that intraoperative blood loss/blood volume also increased significantly when the patient was male and with a greater number of levels fused. Conclusions: There is an inverse relationship between the proportion of blood volume lost during deformity correction surgery and size in patients with adolescent idiopathic scoliosis, cerebral palsy, or Scheuermann kyphosis. Level of Evidence: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Original languageEnglish (US)
Pages (from-to)507-511
Number of pages5
JournalThe Journal of bone and joint surgery. American volume
Volume97
Issue number6
DOIs
StatePublished - Mar 18 2015

Fingerprint

Arthrodesis
Body Size
Blood Volume
Scheuermann Disease
Scoliosis
Cerebral Palsy
Multivariate Analysis
Body Weight
Databases

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Medicine(all)

Cite this

Smaller body size increases the percentage of blood volume lost during posterior spinal arthrodesis. / Jain, Amit; Sponseller, Paul David; Newton, Peter O.; Shah, Suken A.; Cahill, Patrick J.; Njoku, Dolores B; Betz, Randal R.; Samdani, Amer F.; Bastrom, Tracey P.; Marks, Michelle C.

In: The Journal of bone and joint surgery. American volume, Vol. 97, No. 6, 18.03.2015, p. 507-511.

Research output: Contribution to journalArticle

Jain, Amit ; Sponseller, Paul David ; Newton, Peter O. ; Shah, Suken A. ; Cahill, Patrick J. ; Njoku, Dolores B ; Betz, Randal R. ; Samdani, Amer F. ; Bastrom, Tracey P. ; Marks, Michelle C. / Smaller body size increases the percentage of blood volume lost during posterior spinal arthrodesis. In: The Journal of bone and joint surgery. American volume. 2015 ; Vol. 97, No. 6. pp. 507-511.
@article{cdb3e0fe00df49799067eb1102cf1653,
title = "Smaller body size increases the percentage of blood volume lost during posterior spinal arthrodesis",
abstract = "Background: Our goal was to analyze the relationship between patient size and the proportion of blood volume lost during spinal arthrodesis in patients with a diagnosis of adolescent idiopathic scoliosis, Scheuermann kyphosis, or cerebral palsy. We hypothesized that smaller patients (those with less blood volume) lose a greater proportion of circulating total blood volume during surgery. Methods: We reviewed a large, multicenter database, identifying patients with adolescent idiopathic scoliosis (1832), Scheuermann kyphosis (106), or cerebral palsy (196) who had undergone posterior spinal arthrodesis for spinal deformity. Blood volume (estimated from body weight) was used as a measure of patient size. Our primary outcome was the proportion of total circulating blood volume lost (intraoperative blood loss/blood volume, expressed as a percentage). Results: On multivariate analysis, there was a negative relationship between intraoperative blood loss/blood volume and blood volume in patients with adolescent idiopathic scoliosis (coefficient, -5.8; p <0.001), Scheuermann kyphosis (coefficient, -2.5; p <0.001), or cerebral palsy (coefficient, -20.3; p <0.001), indicating that, despite adjustment for all other factors, smaller patients lost a greater proportion of their blood volume. In patients with adolescent idiopathic scoliosis or Scheuermann kyphosis, multivariate analysis showed that intraoperative blood loss/blood volume also increased significantly when the patient was male and with a greater number of levels fused. Conclusions: There is an inverse relationship between the proportion of blood volume lost during deformity correction surgery and size in patients with adolescent idiopathic scoliosis, cerebral palsy, or Scheuermann kyphosis. Level of Evidence: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.",
author = "Amit Jain and Sponseller, {Paul David} and Newton, {Peter O.} and Shah, {Suken A.} and Cahill, {Patrick J.} and Njoku, {Dolores B} and Betz, {Randal R.} and Samdani, {Amer F.} and Bastrom, {Tracey P.} and Marks, {Michelle C.}",
year = "2015",
month = "3",
day = "18",
doi = "10.2106/JBJS.N.01104",
language = "English (US)",
volume = "97",
pages = "507--511",
journal = "Journal of Bone and Joint Surgery - Series A",
issn = "0021-9355",
publisher = "Journal of Bone and Joint Surgery Inc.",
number = "6",

}

TY - JOUR

T1 - Smaller body size increases the percentage of blood volume lost during posterior spinal arthrodesis

AU - Jain, Amit

AU - Sponseller, Paul David

AU - Newton, Peter O.

AU - Shah, Suken A.

AU - Cahill, Patrick J.

AU - Njoku, Dolores B

AU - Betz, Randal R.

AU - Samdani, Amer F.

AU - Bastrom, Tracey P.

AU - Marks, Michelle C.

PY - 2015/3/18

Y1 - 2015/3/18

N2 - Background: Our goal was to analyze the relationship between patient size and the proportion of blood volume lost during spinal arthrodesis in patients with a diagnosis of adolescent idiopathic scoliosis, Scheuermann kyphosis, or cerebral palsy. We hypothesized that smaller patients (those with less blood volume) lose a greater proportion of circulating total blood volume during surgery. Methods: We reviewed a large, multicenter database, identifying patients with adolescent idiopathic scoliosis (1832), Scheuermann kyphosis (106), or cerebral palsy (196) who had undergone posterior spinal arthrodesis for spinal deformity. Blood volume (estimated from body weight) was used as a measure of patient size. Our primary outcome was the proportion of total circulating blood volume lost (intraoperative blood loss/blood volume, expressed as a percentage). Results: On multivariate analysis, there was a negative relationship between intraoperative blood loss/blood volume and blood volume in patients with adolescent idiopathic scoliosis (coefficient, -5.8; p <0.001), Scheuermann kyphosis (coefficient, -2.5; p <0.001), or cerebral palsy (coefficient, -20.3; p <0.001), indicating that, despite adjustment for all other factors, smaller patients lost a greater proportion of their blood volume. In patients with adolescent idiopathic scoliosis or Scheuermann kyphosis, multivariate analysis showed that intraoperative blood loss/blood volume also increased significantly when the patient was male and with a greater number of levels fused. Conclusions: There is an inverse relationship between the proportion of blood volume lost during deformity correction surgery and size in patients with adolescent idiopathic scoliosis, cerebral palsy, or Scheuermann kyphosis. Level of Evidence: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

AB - Background: Our goal was to analyze the relationship between patient size and the proportion of blood volume lost during spinal arthrodesis in patients with a diagnosis of adolescent idiopathic scoliosis, Scheuermann kyphosis, or cerebral palsy. We hypothesized that smaller patients (those with less blood volume) lose a greater proportion of circulating total blood volume during surgery. Methods: We reviewed a large, multicenter database, identifying patients with adolescent idiopathic scoliosis (1832), Scheuermann kyphosis (106), or cerebral palsy (196) who had undergone posterior spinal arthrodesis for spinal deformity. Blood volume (estimated from body weight) was used as a measure of patient size. Our primary outcome was the proportion of total circulating blood volume lost (intraoperative blood loss/blood volume, expressed as a percentage). Results: On multivariate analysis, there was a negative relationship between intraoperative blood loss/blood volume and blood volume in patients with adolescent idiopathic scoliosis (coefficient, -5.8; p <0.001), Scheuermann kyphosis (coefficient, -2.5; p <0.001), or cerebral palsy (coefficient, -20.3; p <0.001), indicating that, despite adjustment for all other factors, smaller patients lost a greater proportion of their blood volume. In patients with adolescent idiopathic scoliosis or Scheuermann kyphosis, multivariate analysis showed that intraoperative blood loss/blood volume also increased significantly when the patient was male and with a greater number of levels fused. Conclusions: There is an inverse relationship between the proportion of blood volume lost during deformity correction surgery and size in patients with adolescent idiopathic scoliosis, cerebral palsy, or Scheuermann kyphosis. Level of Evidence: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

UR - http://www.scopus.com/inward/record.url?scp=84925251539&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84925251539&partnerID=8YFLogxK

U2 - 10.2106/JBJS.N.01104

DO - 10.2106/JBJS.N.01104

M3 - Article

C2 - 25788308

AN - SCOPUS:84925251539

VL - 97

SP - 507

EP - 511

JO - Journal of Bone and Joint Surgery - Series A

JF - Journal of Bone and Joint Surgery - Series A

SN - 0021-9355

IS - 6

ER -