Analysis of related risk factors of hidden blood loss after anterior cervical fusion

Background This study was carried out to analyze the risk factors of perioperative blood loss during anterior cervical fusion (ACF) and to provide guidance in perioperative blood management for patients undergoing ACF. Material and methods A retrospective study was conducted on a consecutive series of 219 patients who had undergone anterior cervical corpectomy fusion (ACCF) and anterior cervical discectomy fusion (ACDF) between January 2016 and July 2017. Patients were categorized into a low hidden blood loss (HBL) group or high HBL group. These two groups were compared for demographic distribution and clinical data to investigate the related risk factors of HBL after ACF. Results The results of the comparison between the high and the low HBL groups indicated that age, gender, concurrent medical diseases, prothrombin time (PT), surgical segmentation, operative time, intraoperative bleeding, total drainage, time for extraction of drainage tube, loss of red blood cell volume, preoperative blood volume, perioperative HBL and total perioperative blood loss were statistically significant between the two groups ( P < 0.05). Furthermore, logistic multivariate regression analysis of 13 factors with statistical significance in univariate analysis showed that intraoperative hemorrhage (OR = 0.985, P = 0.000) and total drainage (OR = 0.970, P = 0.000) were risk factors for high HBL. Conclusion The risk factors for HBL after ACF are varied. Multivariate logistic regression analysis showed that intraoperative blood loss and total drainage were risk factors for high HBL. The authors believe that a reasonable surgical strategy, improved surgical techniques, rational use of hemostatics during surgery, decreased intraoperative blood loss and total drainage can help to reduce HBL.