Factors Related to Blood Loss During Endoscopic Sinus Surgery

The safety and efficacy of endoscopic sinus surgery have improved with the development of new equipment and improved surgical techniques. However, it is accompanied by the risk of complications. Intraoperative blood loss is an important factor in the safe conduct of surgery. Therefore, we examined the factors associated with intraoperative blood loss.

The amount of intraoperative bleeding experienced by 518 patients with sinonasal disease who underwent endoscopic sinus surgery under general anaesthesia at our hospital over nine years was tabulated. Thirty-four variables were extracted after analysis of patients' background, sinonasal pathology, and haematology results. Multivariate linear regression analysis was performed.

Multivariate analysis revealed significant differences in the prothrombin time-international normalized ratio (PT-INR), Lund-Mackay score, operative time, and initial versus repeat surgery. The degree of change between the 25% and 75% points was significant for the following variables: an increase from 5 to 14 points for the Lund-Mackay score at 73 mL.

Preoperative precautionary measures should be implemented in the event of re-operation, expected prolonged operative time, high Lund-Mackay score, and prolonged PT-INR. Intraoperative blood loss in patients with a high Lund-Mackay score requires meticulous attention.