Related Experiment Video
Updated: Sep 13, 2025
Surgical Approach and Complications of Stand-alone Lateral Trans-Psoas Interbody Fusion
Published on: February 14, 2025
Low mean platelet volume: a risk factor for increased intraoperative blood loss in degenerative lumbar surgery
Ehsan Alimohammadi1, Alireza Sadeghsalehi2, Fatemeh Ranjbari3
1Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Background:
Major intraoperative blood loss (MIBL) is associated with increased morbidity and poorer outcomes. This study investigates whether preoperative mean platelet volume (MPV) may serve as a predictive biomarker for MIBL in patients undergoing degenerative lumbar surgery.
Methods:
A retrospective review of 421 patients with lumbar degenerative disease who underwent surgery from July 2019 to July 2022 was conducted. MIBL was defined as blood loss > 1000 ml. Patients were divided into MIBL and non-MIBL groups. Potential risk factors, including MPV, were compared. The optimal MPV cutoff (10.1) was determined using ROC analysis and Youden's index. Patients were grouped into high MPV (≥10.1 fL)and low MPV ( < 10.1 fL). Logistic regression identified independent risk factors for MIBL.
Results:
The cohort included 192 males (45.6%) and 229 females (54.4%), with a mean age of 61.4 ± 8.6 years. MIBL occurred in 73 patients (17.3%). The MPV distribution was 37.8% ( < 10.1 fL) and 62.2% (≥10.1 fL). Logistic regression revealed that higher mean arterial pressure (OR 3.11, 95% CI 1.72-5.21, p < 0.001), greater number of fused levels (OR 2.73, 95% CI 1.72-4.53, p = 0.016), longer surgical duration (OR 1.89, 95% CI 1.43-2.89, p = 0.021), and lower MPV (OR 1.72, 95% CI 1.17-2.26, p = 0.027)were independently associated with MIBL.
Conclusions:
Lower MPV may indicate an increased risk of intraoperative blood loss in lumbar degenerative surgery. Monitoring MPV - a simple, cost-effective biomarker - may assist in optimizing fluid management and blood conservation strategies. However, given the retrospective nature of this study, these findings should be interpreted with caution.
Insights
Lower mean platelet volume (MPV) may predict major intraoperative blood loss in patients undergoing lumbar surgery. This simple biomarker can help optimize blood conservation strategies during these procedures.
Area of Science:
- Neurosurgery
- Hematology
- Surgical Outcomes
Background:
- Major intraoperative blood loss (MIBL) is a significant concern in spinal surgery, linked to increased patient morbidity and adverse outcomes.
- Identifying predictive biomarkers for MIBL is crucial for proactive management and improved surgical safety.
Purpose of the Study:
- To investigate the potential of preoperative mean platelet volume (MPV) as a predictive biomarker for MIBL in patients undergoing degenerative lumbar surgery.
- To determine the association between MPV levels and the occurrence of MIBL.
Main Methods:
- A retrospective analysis of 421 patients who underwent degenerative lumbar surgery between July 2019 and July 2022.
- Patients were categorized into MIBL (>1000 ml blood loss) and non-MIBL groups. MPV was assessed, and logistic regression was used to identify independent risk factors.
- Receiver operating characteristic (ROC) analysis determined an optimal MPV cutoff of 10.1 fL.
Main Results:
- MIBL was observed in 17.3% of the patient cohort.
- Logistic regression identified higher mean arterial pressure, increased number of fused levels, longer surgical duration, and lower MPV as independent predictors of MIBL.
- A lower MPV (cutoff 10.1 fL) was significantly associated with an increased risk of MIBL (OR 1.72, 95% CI 1.17-2.26, p=0.027).
Conclusions:
- Preoperative mean platelet volume (MPV) may serve as a valuable and cost-effective biomarker for predicting major intraoperative blood loss in degenerative lumbar surgery.
- Monitoring MPV can aid in tailoring fluid management and blood conservation strategies, potentially improving patient outcomes.
- Further prospective studies are recommended to validate these findings due to the retrospective nature of this research.
