scholarly journals Analysis of Risk Factors for Perioperative Hidden Blood Loss in Unilateral Biportal Endoscopic Spine Surgery: A Retrospective Multicenter Study

2021 ◽  
Author(s):  
Haosheng Wang ◽  
Kai Wang ◽  
Bin Lv ◽  
Wenle Li ◽  
Tingting Fan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Linear Regression ◽  
Blood Loss ◽  
Spine Surgery ◽  
Linear Regression Analysis ◽  
Total Blood Loss ◽  
Total Blood ◽  
Hidden Blood Loss ◽  
Independent Risk Factors

Abstract Background Hidden blood loss (HBL) represents an important complication of unilateral biportal endoscopic (UBE) spine surgery. This study aimed to evaluate HBL and it’s possible risk factors among patients undergoing UBE surgery for lumbar degenerative diseases. Methods This multicentric retrospective study was conducted in 3 different medical centers between July 2020 and April 2021. Data of patients underwent UBE surgery were extracted by electronic medical record system. The patient’s demographic characteristics and blood loss-related parameters were recorded. We calculated the amount of HBL and explored the association between patient’s characteristics and HBL using Pearson or Spearman correlation analysis. Multivariate linear regression analysis was conducted to identity independent risk factors of HBL. Results A total of 136 patients (55 females and 81 males, age range 43 to 74 years) were included in this study. A substantial amount of HBL (469.5 ± 195.3 ml, 57.6 % of TBL, total blood loss) occurred following UBE surgery. Multiple linear regression analysis indicated that the risk factors of HBL were as follows: age (P = 0.000), number of fusion levels (P = 0.015), American Society of Anesthesiologists (ASA) classification (P = 0.046), surgery time (P = 0.017), patient’s blood volume (PBV, P = 0.026), total blood loss (TBL, P = 0.001), postoperative (i.e., day 2 or 3) hematocrit(Hct, P = 0.034), Hct loss (P = 0.005), and fibrinogen (P = 0.028). Conclusions A certain amount of HBL occurs in UBE surgery and cannot be ignored in daily clinical practice. The age, number of fusion levels, ASA classification, surgery time, PBV, TBL, postoperative Hct, Hct loss, and fibrinogen are independent risk factors for HBL.

scholarly journals Analysis of risk factors for perioperative hidden blood loss in unilateral biportal endoscopic spine surgery: a retrospective multicenter study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Haosheng Wang ◽  
Kai Wang ◽  
Bin Lv ◽  
Wenle Li ◽  
Tingting Fan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Linear Regression ◽  
Blood Loss ◽  
Spine Surgery ◽  
Linear Regression Analysis ◽  
Total Blood Loss ◽  
Total Blood ◽  
Hidden Blood Loss ◽  
Independent Risk Factors

Abstract Background Hidden blood loss (HBL) represents an important complication of unilateral biportal endoscopic (UBE) spine surgery. This study aimed to evaluate HBL and its possible risk factors among patients undergoing UBE surgery for lumbar degenerative diseases. Methods This multicentric retrospective study was conducted in 3 different medical centers between July 2020 and April 2021. Data of patients who underwent UBE surgery were extracted by electronic medical record system. The patient’s demographic characteristics and blood loss-related parameters were recorded. We calculated the amount of HBL and explored the association between patient’s characteristics and HBL using Pearson or Spearman correlation analysis. Multivariate linear regression analysis was conducted to identify independent risk factors of HBL. Results A total of 136 patients (55 females and 81 males, age range 43 to 74 years) were included in this study. A substantial amount of HBL (469.5 ± 195.3 ml, 57.6% of TBL, total blood loss) occurred following UBE surgery. Multiple linear regression analysis indicated that the risk factors of HBL were as follows: age (P = 0.000), number of fusion levels (P = 0.015), American Society of Anesthesiologists (ASA) classification (P = 0.046), surgery time (P = 0.017), patient’s blood volume (PBV, P = 0.026), total blood loss (TBL, P = 0.001), postoperative (i.e., day 2 or 3) hematocrit (Hct, P = 0.034), Hct loss (P = 0.005), and fibrinogen (P = 0.028). Conclusions A certain amount of HBL occurs in UBE surgery and cannot be ignored in daily clinical practice. The age, number of fusion levels, ASA classification, surgery time, PBV, TBL, postoperative Hct, Hct loss, and fibrinogen are independent risk factors for HBL.

scholarly journals Hidden Blood Loss and Factors in Shoulder Arthroscopy Surgery: A Review of 59 Patients

2021 ◽  
Author(s):  
Nie Jiangbo ◽  
Mingchao Jin ◽  
Tianshun Fang ◽  
Xi Liu ◽  
Haowei Jiang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Linear Regression ◽  
Blood Loss ◽  
Operative Time ◽  
Shoulder Arthroscopy ◽  
Linear Regression Analysis ◽  
Multivariate Linear Regression ◽  
Multivariate Linear Regression Analysis ◽  
Hidden Blood Loss

Abstract Purpose: Subacromial impingement syndrome (SIS) and its related rotator cuff tears are the most important cause of shoulder joint pain, which has recently received greater attention. Arthroscopy is a safe, effective, and minimally invasive procedure for the treatment of stage Ⅱ or Ⅲ SIS. Previous studies have reported that little blood loss usually occurs during this procedure. However, significant perioperative hidden blood loss (HBL) is often overlooked. In this respect, we herein aimed to investigate the amount of HBL and identify its possible risk factors.Methods: We enrolled 59 patients with SIS who received shoulder arthroscopy between December 2019 and June 2020 in this study. The clinical data recorded included the height of patients, weight pre- and postoperative hematocrit (Hct), which were used to calculate HBL using Gross’s formula. We analyzed the risk factors, including sex, age, BMI (body mass index), stage of SIS, diabetes, hypertension, and operative time using multivariate linear regression analysis.Results: Our results revealed that the mean of HBL was 341.4 ± 214.9 mL, while that of the postoperative Hb loss was 13.3 ± 8.0 g/L. The incidence of postoperative anemia was significantly associated with HBL (χ2 = 14.496, P < 0.001). Furthermore, multivariate linear regression analysis demonstrated that all seven factors, including gender (P = 0.698), age (P = 0.553), BMI (P = 0.854), stage of SIS (P = 0.906), diabetes (P = 0.984), hypertension (P = 0.532), and operative time (P = 0.645), were not significantly associated with HBL. Conclusion: Findings from this study show that postoperative HBL following shoulder arthroscopy was significant, which can aggravate anemia or lead to secondary anemia, thus should not be neglected.

scholarly journals Hidden blood loss and its possible risk factors in minimally invasive transforaminal lumbar interbody fusion

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Yuanxing Zhou ◽  
Xin Fu ◽  
Ming Yang ◽  
Song Ke ◽  
Bo Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Linear Regression ◽  
Blood Loss ◽  
Interbody Fusion ◽  
Fibrinogen Level ◽  
Muscle Thickness ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Hidden Blood Loss ◽  
Independent Risk Factors

Abstract Background With respect to spinal surgeries, elucidating absolute and relative amount of hidden blood loss (HBL) is of great importance in order to avoid aforementioned potential complications. To evaluate HBL and its possible risk factors among patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for lumbar degenerative diseases. Methods Between June 2018 and March 2019, 137 consecutive patients with lumbar degenerative disease, who underwent operation with MIS-TLIF technique, were enrolled in this study. The patient’s demographic characteristics and blood loss-related parameters were collected, respectively. The Pearson or Spearman correlation analysis was used to investigate an association between patient’s characteristics and HBL. Multivariate linear regression analysis was used to confirm independent risk factors of HBL. Results A total of 137 patients (86 males and 51 females, age range 19–78 years) were reviewed in our hospital. A substantial amount of HBL (488.4 ± 294.0 ml, 52.5% of TBL) occurred after MIS-TLIF. Multivariate linear regression showed that the age, muscle thickness, the Patients’ Society of Anesthesiologists (ASA) classification, patient’s blood volume (PBV), total blood loss (TBL), postoperative (i.e., day 2 or 3) hematocrit (Hct), Hct loss, and fibrinogen level were independent risk factors for HBL (P1 = 0.000, P2 = 0.002, P3 = 0.006, P4 = 0.002, P5 = 0.003, P6 = 0.048, P7 = 0.004, P8 = 0.000). Conclusion A large amount of HBL was incurred in patients undergoing MIS-TLIF. More importantly, the age, muscle thickness, ASA classification, PBV, TBL, postoperative Hct, Hct loss, and fibrinogen level were independent risk factors for HBL in MIS-TLIF. HBL and its risk factors should be paid more attention to during the perioperative period.

scholarly journals Hidden Blood Loss in Percutaneous Endoscopic Lumbar Discectomy (PELD): A Prospective Study

2021 ◽  
Author(s):  
Chong Chen ◽  
Dan Xiao ◽  
Honglin Gu ◽  
Guoyan Liang ◽  
Ruiying Zhang ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Linear Regression ◽  
Blood Loss ◽  
Chronic Diseases ◽  
Linear Regression Analysis ◽  
Lumbar Discectomy ◽  
Symptom Duration ◽  
Multivariate Linear Regression Analysis ◽  
Hidden Blood Loss ◽  
Endoscopic Lumbar Discectomy

Abstract Background: Percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive technique for treatment of lumbar disc herniation (LDH) that requires only an eight-mm skin incision and promotes faster recovery. It is widely believed that the procedure is associated with minimal blood loss. However, significant perioperative hidden blood loss (HBL) is frequently unaccounted for. This study aimed to investigate HBL and peri-operative factors contributing to HBL in a series of individuals undergoing PELD.Methods: As a prospective observational study, 156 patients, mean age 41.6 years (ranged from 17 to 71), undergoing PELD were finally enrolled between May 2019 and November 2020. The analyzed factors included gender, age, body mass index (BMI), symptom duration, operation approach/technique, operation duration, the presence of associated chronic diseases (e.g., hypertension, rheumatoid arthritis, and diabetes mellitus), and improvements in Visual Analog Scale (VAS), Japanese Orthopedic Association (JOA), and Oswestry Disability Index (ODI) scores. Gross’s formula was applied to calculate blood loss from recorded values for patient height, weight, and hematocrit levels before and after surgery. Multivariate linear regression analysis and t test were performed to identify factors that contributed significantly to HBL.Results: The mean HBL during PELD was 201 ± 126 mL, and the Hb reduction observed post-operatively was 7.4 ± 4.5 g/L. A lateral surgical approach was associated with greater HBL compared with an interlaminar approach. However, no significant differences in VAS, JOA, and ODI score improvements were noted between the two surgical approaches. Increased surgical times and foraminal decompression were identified by multivariate linear regression analysis as linked to increased HBL. As expected, the occurrence of post-operative anemia was significantly associated with HBL. Age, gender, BMI, symptom duration, and associated chronic diseases showed no association with increased HBL during PELD. Conclusions: HBL is increased in PELD patients with long surgical times and lumbar foraminal decompression.

scholarly journals Hidden blood loss and its possible risk factors in minimally invasive transforaminal lumbar interbody fusion

2020 ◽  
Author(s):  
Yuanxing Zhou ◽  
Jianlong Deng ◽  
Xin Fu ◽  
Ming Yang ◽  
Yu Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Linear Regression ◽  
Blood Loss ◽  
Interbody Fusion ◽  
Fibrinogen Level ◽  
Muscle Thickness ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Hidden Blood Loss ◽  
Independent Risk Factors

Abstract Background Hidden blood loss (HBL) is still not well known or used in the setting of spine surgery. Elucidating absolute and relative amount of HBL is of great importance in order to avoid potential complications. Therefore, we evaluated HBL and its possible risk factors among patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for lumbar degenerative diseases. Methods Between June 2018 and March 2019, 137 consecutive patients with lumbar degenerative disease, who underwent operation with MIS-TLIF technique were enrolled in this study. The patient’s demographic characteristics and blood loss related parameters were collected respectively. Pearson or Spearman correlations analysis were used to investigate an association between patient’s characteristics and HBL. Multivariate linear regression analysis was used to confirmed independent risk factors of HBL. Results A total of 137 patients (86 males and 51 females, age range 19-78 years) were reviewed in our hospital. A substantial amount of HBL (488.4±294.0 ml, 52.5% of TBL) occurred after MIS-TLIF. Multivariate linear regression showed that the age, muscle thickness, The Patients’ Society of Anesthesiologists (ASA) classification, patient’s blood volume (PBV), total blood loss (TBL), postoperative(i.e., day 2 or 3) hematocrit (Hct), Hct loss, and fibrinogen level were independent risk factors for HBL (P1=0.000, P2=0.002, P3=0.006, P4=0.002, P5=0.003, P6=0.048, P7=0.004, P8=0.070). Conclusion A large amount of HBL was incurred in patients undergoing MIS-TLIF. More importantly, the age, muscle thickness, ASA classification, PBV, TBL, postoperative Hct, Hct loss, and fibrinogen level were independent risk factors for HBL in MIS-TLIF. HBL and its risk factors should be paid more attention to during perioperative period.

scholarly journals Hidden blood loss in adolescent idiopathic scoliosis patients undergoing posterior spinal fusion surgery: a retrospective study of 765 cases at a single centre

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Lipeng Wang ◽  
Jiangli Liu ◽  
Xiaoxiao Song ◽  
Muhui Luo ◽  
Yongquan Chen
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Adolescent Idiopathic Scoliosis ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Idiopathic Scoliosis ◽  
Posterior Spinal Fusion ◽  
Hidden Blood Loss ◽  
Postoperative Blood Transfusion ◽  
Independent Risk Factors

Abstract Background In scoliosis corrective surgery, total blood loss is composed of visible blood loss, including intraoperative haemorrhage and drainage, and hidden blood loss in which blood extravasates into the tissues and accumulates in the surgical field. The purpose of this study was to investigate hidden blood loss (HBL) and its potential risk factors in adolescent idiopathic scoliosis patients undergoing posterior spinal fusion surgery and elucidate the influence of HBL on the necessity for postoperative blood transfusion. Methods We retrospectively studied adolescent idiopathic scoliosis patients undergoing posterior spine fusion for adolescent idiopathic scoliosis from January 2014 to December 2018 at our hospital. The patients’ demographics, blood loss-related parameters, surgeries and blood loss data were extracted. The association between patient characteristics and HBL was analyzed by Pearson or Spearman correlation analyses. Multivariate linear regression analysis was used to determine independent risk factors associated with HBL. Binary logistic regression analysis was used to analyze the influence of HBL on the necessity for postoperative blood transfusion. Results A total of 765 patients, of whom 128 were male and 637 were female (age range 10–18 years), were included in this study. The mean volume of HBL was 693.5 ± 473.4 ml, accounting for 53.9 % of the total blood loss. The multivariate linear regression analysis revealed that preoperative Hct (p = 0.003) and allogeneic blood transfusion (p < 0.001) were independent risk factors for HBL, while tranexamic acid (p = 0.003) was negatively correlated with HBL. Binary logistic regression analysis showed that HBL > 850 ml (P < 0.001, OR: 8.845, 95 % CI: 5.806–13.290) was an independent risk factor for the necessity for postoperative blood transfusion. Conclusions Substantial HBL occurred in adolescent idiopathic scoliosis patients undergoing posterior spinal fusion surgeries. Allogeneic blood transfusion and preoperative Hct were independent risk factors for HBL, while tranexamic acid was negatively related to HBL. HBL and its influencing factors should be considered when planning perioperative transfusion management. Patients with HBL greater than 850 ml should be closely monitored in cases of postoperative anaemia. Level of evidence Level III.

scholarly journals Hidden Blood Loss in Percutaneous Endoscopic Lumbar Discectomy (PELD): a Prospective Study

2021 ◽  
Author(s):  
Chong Chen ◽  
Dan Xiao ◽  
Honglin Gu ◽  
Guoyan Liang ◽  
Ruiying Zhang ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Linear Regression ◽  
Blood Loss ◽  
Chronic Diseases ◽  
Linear Regression Analysis ◽  
Lumbar Discectomy ◽  
Symptom Duration ◽  
Multivariate Linear Regression Analysis ◽  
Hidden Blood Loss ◽  
Endoscopic Lumbar Discectomy

Abstract Background: Percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive technique for treatment of lumbar disc herniation (LDH) that requires only an eight-mm skin incision and promotes faster recovery. It is widely believed that the procedure is associated with minimal blood loss. However, significant perioperative hidden blood loss (HBL) is frequently unaccounted for. This study aimed to investigate HBL and peri-operative factors contributing to HBL in a series of individuals undergoing PELD.Methods: As a prospective observational study, 156 patients, mean age 41.6 years (ranged from 17 to 71), undergoing PELD were finally enrolled between May 2019 and November 2020. The analyzed factors included gender, age, body mass index (BMI), symptom duration, operation approach/technique, operation duration, the presence of associated chronic diseases (e.g., hypertension, rheumatoid arthritis, and diabetes mellitus), and improvements in Visual Analog Scale (VAS), Japanese Orthopedic Association (JOA), and Oswestry Disability Index (ODI) scores. Gross’s formula was applied to calculate blood loss from recorded values for patient height, weight, and hematocrit levels before and after surgery. Multivariate linear regression analysis and t test were performed to identify factors that contributed significantly to HBL.Results: The mean HBL during PELD was 201 ± 126 mL, and the Hb reduction observed post-operatively was 7.4 ± 4.5 g/L. A lateral surgical approach was associated with greater HBL compared with an interlaminar approach. However, no significant differences in VAS, JOA, and ODI score improvements were noted between the two surgical approaches. Increased surgical times and foraminal decompression were identified by multivariate linear regression analysis as linked to increased HBL. As expected, the occurrence of post-operative anemia was significantly associated with HBL. Age, gender, BMI, symptom duration, and associated chronic diseases showed no association with increased HBL during PELD. Conclusions: HBL is increased in PELD patients with long surgical times and lumbar foraminal decompression.

scholarly journals Intraoperative blood loss in oncological spine surgery

2021 ◽  
Vol 50 (5) ◽  
pp. E14
Author(s):  
Malte Mohme ◽  
Klaus C. Mende ◽  
Tobias Pantel ◽  
Lennart Viezens ◽  
Manfred Westphal ◽  
...  
Keyword(s):  
At Risk ◽  
Regression Analysis ◽  
Linear Regression ◽  
Blood Loss ◽  
Multiple Linear Regression ◽  
Spine Surgery ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Intraoperative Blood Loss ◽  
Patients At Risk

OBJECTIVE Intraoperative blood loss in patients undergoing oncological spine surgery poses a major challenge for vulnerable patients. The goal of this study was to assess how the surgical procedure, tumor type, and tumor anatomy, as well as anesthesiological parameters, affect intraoperative blood loss in oncological spine surgery and to use this information to generate a short preoperative checklist for spine surgeons and anesthesiologists to identify patients at risk for increased intraoperative blood loss. METHODS The authors performed a retrospective analysis of 430 oncological patients who underwent spine surgery between 2013 and 2018 at the university medical spine center. Enrolled patients had metastatic tumor of the spine requiring surgical decompression of neural structures and/or stabilization including tumor biopsy using an open, percutaneous, and/or combined dorsoventral approach. Patients requiring vertebro- and kyphoplasty or biopsy only were excluded. Statistical analyses performed included a multiple linear regression analysis. RESULTS The mean intraoperative blood loss in the study patient cohort was 1176 ± 1209 ml. In total, 33.8% of patients received intraoperative red blood cell transfusions. The statistical analyses showed that tumor histology indicating myeloma, operative procedure length, epidural spinal cord compression (ESCC) score, tumor localization, BMI, and surgical strategy were significantly associated with increased intraoperative blood loss or risk of needing allogeneic blood transfusions. Anesthesiological parameters such as the American Society of Anesthesiologists (ASA) Physical Status classification score were not associated with blood loss. Multiple linear regression analysis demonstrated good predictive value (r = 0.437) for a five-item preoperative checklist to identify patients at risk for high intraoperative blood loss. CONCLUSIONS The analyses performed in this study demonstrated key factors affecting intraoperative blood loss and showed that a simple preoperative checklist including these factors can be used to identify patients undergoing surgery for metastatic spine tumors who are at risk for increased intraoperative blood loss.

scholarly journals Does the correction angle affect hidden blood loss in HTO?

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Zheng Li ◽  
Yannong Wang ◽  
Guanglei Cao ◽  
Shuai An ◽  
Mingli Feng ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Blood Loss ◽  
High Tibial Osteotomy ◽  
Total Blood Loss ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Total Blood ◽  
Correction Angle ◽  
Hidden Blood Loss ◽  
Wedge High Tibial Osteotomy

Abstract Background High tibial osteotomy (HTO) has a history of nearly 60 years and has been widely used in clinical practice. Biplanar open wedge high tibial osteotomy (BOWHTO), which evolved from HTO, is an important therapy for the knee osteoarthritis. In our previous research, we found that the decrease of hemoglobin levels after high tibial osteotomy ranges from between 17 to 41 g/L, but this is highly inconsistent with the intraoperative bleeding and postoperative drainage observed in clinical practice. The purpose of this study was to investigate the perioperative hidden blood loss (HBL) after biplanar open wedge high tibial osteotomy (BOWHTO), as well as to study the effect of the actual correction angle on blood loss. Methods A retrospective analysis was performed on 21 patients who underwent BOWHTO for osteoarthritis of the knee due to proximal tibia deformity. Gross equation was used to calculate the perioperative total blood loss (TBL) and HBL. The actual correction angle was measured by postoperative anteroposterior radiograph. The correlation between HBL and correction angle was determined through correlation analysis. Results The TBL was 823.5 ± 348.7 mL and the HBL was 601.6 ± 297.3 mL, total hemoglobin loss was 25.0 ± 10.7 g/L, and the mean HBL/patient’s blood volume (H/P) was 13.19 ± 5.56% for 21 patients. The correlation coefficient of correction angle and H/P is statistically significant (|r| = 0.678, P = 0.001). Conclusions The actual total blood loss after BOWHTO was significantly higher than the observed, and the HBL was objective existent after BOWHTO. The proportion of H/P is positively correlated with the correction angle.

scholarly journals Hidden Blood Loss in Adolescent Idiopathic Scoliosis Patients Undergoing Posterior Spinal Fusion Surgery: A Retrospective Study of 765 Cases in a Single Center

2021 ◽  
Author(s):  
Lipeng Wang ◽  
Jiangli Liu ◽  
Xiaoxiao Song ◽  
Muhui Luo ◽  
Yongquan Chen
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Adolescent Idiopathic Scoliosis ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Idiopathic Scoliosis ◽  
Spinal Fusion ◽  
Posterior Spinal Fusion ◽  
Postoperative Blood Transfusion ◽  
Independent Risk Factors

Abstract Purpose: To investigate Hidden blood loss (HBL) and its potential risk factors in adolescent idiopathic scoliosis patients undergoing posterior spinal fusion surgery and elucidate the influence of HBL on postoperative blood transfusion. Methods: We retrospectively studied 765 patients undergoing posterior spine fusion for adolescent idiopathic scoliosis from January 2014 to December 2018. The patient’s demographics, blood loss related parameters, operation and blood loss information were extracted. The association between patient’s characteristics and HBL was analyzed by Pearson or Spearman correlation analysis. Multivariate linear regression analysis was used to determine independent risk factors associated with HBL. Binary logistic regression analysis was used to analyze the influence of HBL on postoperative blood transfusion.Results: A total of 765 patients including 128 males and 637 females (age range 10-18 years) were included in this study. The mean amount of HBL was 693.5±473.4 ml, accounting for 53.9% of the total blood loss. In multivariate linear regression analysis, we found that preoperative Hct (p=0.003) and allogeneic blood transfusion (p<0.0001) were independent risk factors for HBL, while tranexamic acid (p=0.003) was negatively related to HBL. Binary logistic regression analysis showed that HBL > 850 ml ( P < 0.001, OR: 8.845, 95%CI: 5.806-13.290) was the independent risk factor for postoperative blood transfusion.Conclusion: a large amount of HBL was incurred in adolescent idiopathic scoliosis patients undergoing posterior spinal fusion surgeries. Allogeneic blood transfusion and preoperative Hct were independent risk factors for HBL, while tranexamic acid was negatively related to HBL. HBL and its influential factors should be taken into account when considering the perioperative transfusion management. These patients with HBL greater than 850 ml should be paid more attention in case of postoperative anemia.Level of evidence: Level III

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