Einfluss des perioperativen Blutverlustes bei Wirbelsäulen-Operationen auf die postoperative Infektionsrate
Loading...
Date
Authors
Publisher
Abstract
Postoperative infections are considered one of the most serious complications in many surgical
fields. This retrospective, single-centre study aimed to investigate perioperative blood loss as a
potential risk factor for postoperative infection. Previous studies have primarily focused on
intraoperative blood loss as a risk factor, neglecting hidden blood loss, which can account for up
to half of the total blood loss.
For this study, 705 spine surgeries performed between 2017 and 2024 at the University Hospital
of Marburg (Department of Orthopaedics and Trauma Surgery) were analysed. Demographic
patient data, laboratory parameters, as well as surgery-related variables (e. g. duration and type
of surgery) were recorded. Blood loss was calculated as the sum of compensated blood loss,
represented by the number of transfused erythrocyte concentrates, and non-compensated
blood loss, which was determined from the individual total blood volume and the difference
between pre- and postoperative haematocrit. Data collection and statistical analysis were
performed using IBM SPSS Statistics version 27 and Microsoft Excel version 2501.
The postoperative infection rate was 3.55 % (n = 25). The mean perioperative blood loss was
422.64 ml (± 417.3 ml). Univariate analysis revealed a significant association between
perioperative blood loss and the risk of postoperative infection (p < 0.001). In addition, male
gender (p < 0.001), body weight (p < 0.001), duration of surgery (p < 0.001), length of hospital
stay (p < 0.001), erythrocyte transfusion (p < 0.001) and the preoperative laboratory values
platelet count (p < 0.001) and Quick (p < 0.001) showed statistical associations with blood loss
and infection risk. However, in multivariate logistic regression, only the length of hospital stay
proved to be an independent risk factor for postoperative wound infections (p = 0.008).
Despite the lack of multivariate significance for perioperative blood loss, a clinical correlation
still seems conceivable, especially with regard to possible indirect effects. The study once again
underscores the relevance of blood-saving surgical procedures. Additional research is necessary
to further define the influence of perioperative blood loss as a risk factor and to distinguish it
from other influencing factors. The limitations of the blood loss formula and the overall
collective identified can be taken into account and eliminated in prospective studies.
Review
Metadata
License
Except where otherwise noted, this item's license is described as Attribution-NonCommercial-NoDerivatives 4.0 International