Delángel SCBB, Vilchis SH, Pinzón LCY

Language: Spanish
References: 12
Page: 140-147
PDF size: 190.12 Kb.

ABSTRACT

Introduction: major trans-surgical bleeding associated with posterior instrumented arthrodesis in pediatric patients with scoliosis can be catastrophic for the patient's health status. Material and methods: descriptive, observational, retrospective study, designed in a case model, identifying pediatric patients diagnosed with scoliosis who underwent surgical treatment of primary instrumented posterior arthrodesis. The cases were the patients who presented major bleeding (> 20% of the total circulating volume) and the controls were those who presented (< 20% of the total circulating volume). Logistic regression was performed to perform a major bleeding prediction model on statistically significant variables. Results: of the 89 patients, with a mean age of 14 years (range 9 to 18 years), 62 (69%) had major bleeding and 27 (30%) had no major bleeding. The following variables had a higher risk of major bleeding: age < 14 years 4.3 times more risk (p = 0.002), body mass index (BMI) < 18.5 has 6.17 times more risk (p = 0.003), > 11 fused levels has 8.5 times more risk (p < 0.000), surgical time > 300 min has 3.7 times more risk (p = 0.040), a Cobb angle > 75° has 3.5 times more risk (p = 0.015). A model was made where the isolated presence of > 11 functioning levels implies a risk of 8.5, adding the variable of age < 14 years increases the risk up to 11.4, and when adding a low BMI, it rises to present a risk from 52. Conclusion: age < 14 years, low BMI, Cobb angle > 75°, prolonged surgical time, > 11 fused levels, are risk factors for the presence of major bleeding.

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