5 year study of CBC changes after scoliosis surgery

Abstract

Scoliosis is one of the most common spinal deformities and due to the fact that the surgical incision to correct the scoliosis deformity is often large, these patients experience high bleeding and loss of high volume of the patient's blood volume requires blood transfusion. Increasing. Increased need for blood transfusions can lead to other postoperative problems and predispose these patients to postoperative complications; Therefore, the prediction and prevention of extensive blood transfusion is essential to improve the clinical outcome of patients. Therefore, in this study, we examine the changes in complete blood cell count in people who are candidates for scoliosis correction surgery over a period of 5 years. Methods: The sample of this study included 70 patients with surgical scoliosis who underwent scoliosis surgery in Shohada-Mahallati and Valiasr International Hospital in Tabriz in the period of 2015-2020. Gender, marital status, body mass index as well as surgery-related information including blood transfusion rate, duration of surgery, bleeding rate and duration of anesthesia were assessed. Also, red blood cell count, white blood cell count, blood platelet count, hemoglobin level, blood hematocrit level before surgery and up to 5 days after surgery were measured and evaluated. Results: The mean age of the sample was 24 18 18.43 years. In the sample, 65.7% were female and 34.3% were male. Examination of weight, height and body mass index showed that 58% of normal physical condition, 22% were obese and 20% were lean. The mean bleeding during the operation was 1213.89 ± 830 ml. In 85% of cases, blood transfusion was performed during surgery. Also, 30% needed blood transfusions after surgery. Intraoperatively infused blood was concentrated in 73% of erythrocytes and in 13% of both freshly frozen platelets and erythrocytes, and the mean total intraoperatively infused blood was 1098.6 ml. The results of linear regression showed that high weight (p = 0.007), low body mass index (p = 0.3) and high duration of surgery (p = 0.007) were significantly associated with high intraoperative transfused blood. The mean duration of hospitalization was 5.88 with a standard deviation of 2.1 days and the duration of hospitalization was positively and significantly related to the duration of surgery. Examination of the trend of changes in the variables of red blood cell count - platelet - hemoglobin and hematocrit showed that the day after surgery had a significant decrease compared to before surgery and this decrease continued until the third day after surgery. In all 4 variables mentioned, the decreasing trend changed after the third day and increased on the fourth day after the operation. The variable of white blood cells one day after surgery had a significant increase compared to before surgery, but from the second to the fifth day after surgery had a decreasing trend. The mean of variables 1 day after surgery was significantly different from before surgery (p <0.5).