A bleeding assessment tool correlates with intraoperative blood loss in children and adolescents undergoing major...

Area of Science:

• Pediatric Surgery
• Hematology
• Anesthesiology

Background:

• Predicting perioperative bleeding risk in pediatric patients, especially for high-risk surgeries like spinal procedures, is challenging.
• Pediatric patients often lack a history of significant hemostatic challenges, complicating risk assessment.
• Routine laboratory screening tests have limited predictive value for operative bleeding in adults and pediatric patients.

Purpose of the Study:

• To evaluate the correlation between a detailed bleeding questionnaire (BQ) score and intraoperative bleeding in pediatric patients undergoing major spinal surgery.
• To compare the predictive value of the BQ with standard laboratory screening studies (PT, aPTT, PFA) for operative bleeding.

Main Methods:

• A retrospective analysis of 220 pediatric patients undergoing major spinal surgery.
• Patients completed a detailed bleeding questionnaire (BQ) preoperatively.
• Routine screening laboratory studies (PT, aPTT, PFA) were drawn concurrently.

Main Results:

• A BQ score greater than 2 demonstrated a strong positive correlation with intraoperative bleeding.
• Univariate and multivariate analyses confirmed the BQ score's predictive value.
• Abnormalities in routine screening laboratory studies showed no significant correlation with operative bleeding outcomes.

Conclusions:

• The bleeding questionnaire (BQ) is a valuable tool for assessing intraoperative bleeding risk in pediatric patients undergoing major spinal surgery.
• Relying solely on standard laboratory screening tests is inadequate for predicting surgical bleeding risk.
• The BQ may help identify low-risk patients who may not require laboratory screening, optimizing pre-surgical evaluation.