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Effectiveness of Platelet Markers ın Estimating the Amount of Intraoperative Bleeding ın Vertebra Surgery

Yıl 2024, Cilt: 14 Sayı: 1, 89 - 98, 31.03.2024

Seliman Çetinbulut Onur Palabıyık Havva Kocayigit Ayça Taş Tuna Davut Ceylan

https://doi.org/10.31832/smj.1421647

Öz

Purpose: One of the most important steps in perioperative bleeding management is the predetermination of the patient at risk. Even if there is no hemostatic abnormality in vertebral surgery, which is a major surgery, severe bleeding can be encountered and many perioperative blood transfusions might be required. In this study; we investigated the effectiveness of preoperative mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), mean platelet volume lymphocyte count ratio (MPVLR), and platelet count to lymphocyte count ratio (PLR) values in predicting the amount of intraoperative bleeding in patients who will undergo vertebral surgery.
Method: Preoperative MPV, PDW, PCT, MPVLR, PLR values and demographic data such as gender, age, ASA score and body mass index (BMI) were recorded in patients scheduled for vertebral surgery in the neurosurgery clinic. In addition, the duration of surgery, the number of vertebral transpedicular screwing and laminectomy levels as surgical procedure were recorded. The amount of intraoperative bleeding was obtained by calculating the amount of blood accumulated in the aspirator and the amount of blood in the sponges during the operation.
Results: Of the 63 patients included in the study, 60.3% (n=38) were female and 39.7% (n=25) were male. The mean age of the patients was 54.7 ± 11 years and the mean BMI was 29.6 ± 4.6. No correlation was found between the amount of bleeding and gender, age, MPV, PDW, PCT, MPVLR, or PLR values. A significantly high correlation was found between amount of bleeding and BMI, duration of surgery, and the number of transpedicular screwing segments.
Conclusion: Platelet markers do not appear to have an effect on the amount of bleeding. However; as the BMI increases, the duration of surgery prolongs and the number of transpedicular screw segments increases for which the amount of bleeding increases.

Anahtar Kelimeler

Intraoperative bleeding amount Mean platelet volume Mean platelet volume lymphocyte ratio Platelet distribution width Plateletcrit Platelet lymphocyte ratio

Kaynakça

  • 1. Vitello DJ, Ripper RM, Fettiplace MR, Weinberg GL, Vitello JM. Blood Density Is Nearly Equal to Water Density: A Validation Study of the Gravimetric Method of Measuring Intraoperative Blood Loss. J Vet Med. 2015;2015:152730. doi:10.1155/2015/152730
  • 2. Malcherczyk D, Klasan A, Ebbinghaus A, et al. Factors affecting blood loss and blood transfusion in patients with proximal humeral fractures. J Shoulder Elbow Surg. 2019;28(6):e165-e174. doi:10.1016/j.jse.2019.01.018
  • 3. Lei F, Li Z, He W, et al. Hidden blood loss and the risk factors after posterior lumbar fusion surgery: A retrospective study. Medicine (Baltimore). 2020;99(19):e20103. doi:10.1097/MD.0000000000020103
  • 4. Zhou Y, Fu X, Yang M, Ke S, Wang B, Li Z. Hidden blood loss and its possible risk factors in minimally invasive transforaminal lumbar interbody fusion. J Orthop Surg Res. 2020;15(1):445. Published 2020 Sep 29. doi:10.1186/ s13018-020-01971-5
  • 5. Abu-Ghanem Y, Mahajna H, Ghinea R, White I, Inbar R, Avital S. Predictive factors for perioperative blood transfusions in laparoscopic colorectal surgery. Int J Colorec tal Dis. 2014;29(6):723-728. doi:10.1007/s00384-014- 1854-6
  • 6. Abu-Ghanem Y, Dotan Z, Kaver I, Ramon J. Predictive factors for perioperative blood transfusions in partial nephrectomy for renal masses. J Surg Oncol. 2015;112(5):496-502. doi:10.1002/jso.24029
  • 7. Nielsen AW, Helm MC, Kindel T, et al. Perioperative bleeding and blood transfusion are major risk factors for venous thromboembolism following bariatric surgery. Surg Endosc. 2018;32(5):2488-2495. doi:10.1007/s00464- 017-5951-9
  • 8. Susmallian S, Danoch R, Raskin B, Raziel A, Barnea R, Dvora P. Assessing Bleeding Risk in Bariatric Surgeries: A Retrospective Analysis Study. Dig Dis. 2020;38(6):449- 457. doi:10.1159/000506456
  • 9. Chang IH, Byun SS, Hong SK, Lee SE. Assessing the body mass index of patients might help to predict blood loss during radical retropubic prostatectomy in Korean men. BJU Int. 2007;99(3):570-574. doi:10.1111/j.1464- 410X.2006.06637.x
  • 10. Wu YS, Zhang H, Zheng WH, Feng ZH, Chen ZX, Lin Y. Hidden blood loss and the influential factors after percutaneous kyphoplasty surgery. Eur Spine J. 2017;26(7):1878- 1883. doi:10.1007/s00586-017-4950-9
  • 11. Chang IH, Byun SS, Hong SK, Lee SE. Assessing the body mass index of patients might help to predict blood loss during radical retropubic prostatectomy in Korean men. BJU Int. 2007;99(3):570-574. doi:10.1111/j.1464- 410X.2006.06637.x
  • 12. Chang SS, Duong DT, Wells N, Cole EE, Smith JA Jr, Cookson MS. Predicting blood loss and transfusion requirements during radical prostatectomy: the significant negative impact of increasing body mass index. J Urol. 2004;171(5):1861-1865. doi:10.1097/01. ju.0000120441.96995.e3
  • 13. Villavicencio A, Lee Nelson E, Rajpal S, Vivek N, Burneikiene S. The impact of BMI on operating room time, blood loss, and hospital stay in patients undergoing spinal fusion. Clin Neurol Neurosurg. 2019;179:19-22. doi:10.1016/j.clineuro.2019.02.012
  • 14. Lei F, Li Z, He W, et al. Hidden blood loss and the risk factors after posterior lumbar fusion surgery: A retrospective study. Medicine (Baltimore). 2020;99(19):e20103. doi:10.1097/MD.0000000000020103
  • 15. Vincent JL, Moreno R. Clinical review: scoring systems in the critically ill. Crit Care. 2010;14(2):207. doi:10.1186/ cc8204
  • 16. Bath P, Algert C, Chapman N, Neal B; PROGRESS Collaborative Group. Association of mean platelet volume with risk of stroke among 3134 individuals with history of cerebrovascular disease. Stroke. 2004;35(3):622-626. doi:10.1161/01.STR.0000116105.26237.EC
  • 17. Özlü MF, Öztürk S, Ayhan SS, et al. Predictive value of mean platelet volume in young patients with non-STsegment elevation acute coronary syndromes: a retrospective observational study. Anadolu Kardiyol Derg. 2013;13(1):57-61. doi:10.5152/akd.2013.007
  • 18. Huang J, Chen Y, Cai Z, Chen P. Diagnostic value of platelet indexes for pulmonary embolism. Am J Emerg Med. 2015;33(6):760-763. doi:10.1016/j.ajem.2015.02.043
  • 19. Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V. Mean Platelet Volume (MPV): New Perspectives for an Old Marker in the Course and Prognosis of Inflammatory Conditions. Mediators Inflamm. 2019;2019:9213074. Published 2019 Apr 17. doi:10.1155/2019/9213074
  • 20. Cetin M, Bakirci EM, Baysal E, et al. Increased platelet distribution width is associated with ST-segment elevation myocardial infarction and thrombolysis failure. Angiology. 2014;65(8):737-743. doi:10.1177/0003319713520068
  • 21. Cetin MS, Ozcan Cetin EH, Akdi A, et al. Platelet distribution width and plateletcrit: novel biomarkers of ST elevation myocardial infarction in young patients. Kardiol Pol. 2017;75(10):1005-1012. doi:10.5603/KP.a2017.0135
  • 22. Chen SY, Lin YS, Cheng YF, Wang H, Niu XT, Zhang WL. Mean Platelet Volume-To-Lymphocyte Ratio Predicts Poor Functional Outcomes Among Ischemic Stroke Patients Treated With Intravenous Thrombolysis. Front Neurol. 2019;10:1274. Published 2019 Dec 10. doi:10.3389/fneur.2019.01274
  • 23. Ming L, Jiang Z, Ma J, Wang Q, Wu F, Ping J. Platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, and platelet indices in patients with acute deep vein thrombosis. Vasa. 2018;47(2):143-147. doi:10.1024/0301-1526/ a000683
  • 24. Şahin M, Elbey B, Şahin A, Yüksel H, Türkcü FM, Çaça İ. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in retinal vein occlusion. Clin Exp Optom. 2020;103(4):490-494. doi:10.1111/cxo.13008
  • 25. Wang Q, Ma J, Jiang Z, Ming L. Prognostic value of neutrophil- to-lymphocyte ratio and platelet-to-lymphocyte ratio in acute pulmonary embolism: a systematic review and meta-analysis. Int Angiol. 2018;37(1):4-11. doi:10.23736/S0392-9590.17.03848-2
  • 26. Telo S, Kuluöztürk M, Deveci F, Kirkil G. The relationship between platelet-to-lymphocyte ratio and pulmonary embolism severity in acute pulmonary embolism. Int Angiol. 2019;38(1):4-9. doi:10.23736/S0392-9590.18.04028-2
  • 27. Zheng F, Cammisa FP Jr, Sandhu HS, Girardi FP, Khan SN. Factors predicting hospital stay, operative time, blood loss, and transfusion in patients undergoing revision posterior lumbar spine decompression, fusion, and segmental instrumentation. Spine (Phila Pa 1976). 2002;27(8):818-824. doi:10.1097/00007632- 200204150-00008
  • 28. Thompson ME, Kohring JM, McFann K, McNair B, Hansen JK, Miller NH. Predicting excessive hemorrhage in adolescent idiopathic scoliosis patients undergoing posterior spinal instrumentation and fusion. Spine J. 2014;14(8):1392-1398. doi:10.1016/j. spinee.2013.08.022

Trombosit Belirteçlerinin Vertebra Cerrahisinde İntraoperatif Kanama Miktarı Tahminindeki Etkinliği

Yıl 2024, Cilt: 14 Sayı: 1, 89 - 98, 31.03.2024

Seliman Çetinbulut Onur Palabıyık Havva Kocayigit Ayça Taş Tuna Davut Ceylan

https://doi.org/10.31832/smj.1421647

Öz

AMAÇ: Perioperatif kanama yönetiminde en önemli basamaklardan birisi risk altındaki hastanın önceden belirlenmesidir. Major bir cerrahi olan vertebra cerrahisinde herhangi bir hemostatik anormallik olmasa bile ciddi kanamayla karşılaşılabilmekte ve perioperatif çok sayıda kan transfüzyonu gerekebilmektedir. Literatürde bugüne kadar vertebra cerrahilerinde intraoperatif kanamada prediktivite açısından trombosit belirteçlerini inceleyen bir araştırma bulunmamaktadır. Bu çalışmada; vertebra cerrahisine girecek hastalarda preoperatif ortalama trombosit hacmi (MPV), trombosit dağılım genişliği (PDW), plateletkrit (PCT), ortalama trombosit hacmi lenfosit sayısı oranı (MPVLR) ve trombosit sayısı lenfosit sayısı oranı (PLR) değerlerinin intraoperatif kanama miktarı tahminindeki etkinliklerini araştırmayı amaçladık.
METOD: Etik kurul onayı alındıktan sonra, beyin cerrahisi kliniğince vertebra cerrahisi planlanan hastalar belirlendi. Hastaların cinsiyet, yaş, ASA skoru ve vücut kitle indeksi (VKİ) gibi demografik verileri, preoperatif MPV, PDW, PCT, MPVLR ve PLR değerleri kaydedildi. Cerrahi süresi, cerrahi prosedür olarak vertebra transpediküler vidalama ve laminektomi seviye sayıları kaydedildi. İntraoperatif kanama miktarı ameliyat süresince aspiratörde biriken kan ve spançlardaki kan miktarı üzerinden gerekli hesaplamalar yapılarak elde edildi.
BULGULAR: Çalışmaya dahil edilen 63 hastanın %60,3’ü (n=38) kadın, %39,7’si (n=25) erkek idi. Hastaların yaş ortalamaları 54,7 ± 11 yıl, ortalama VKİ 29,6 ± 4,6 idi. Cinsiyet, yaş, MPV, PDW, PCT, MPVLR ve PLR ile kanama miktarı arasında korelasyon saptanmadı. VKİ, cerrahi süresi, transpediküler vidalama segment sayısı ile kanama miktarı arasında ise anlamlı derecede yüksek korelasyon saptandı.
SONUÇ: Sonuç olarak; trombosit belirteçlerinin kanama miktarına etkisi görülmemektedir. Bununla birlikte, VKİ arttıkça, cerrahi süre uzadıkça, transpediküler vida segment sayısı arttıkça kanama miktarı artmaktadır.

Anahtar Kelimeler

İntraoperatif Kanama Miktarı Ortalama Trombosit Hacmi Trombosit Dağılım Genişliği Plateletkrit Ortalama Trombosit Hacmi Lenfosit Oranı Trombosit Lenfosit Oranı

Kaynakça

  • 1. Vitello DJ, Ripper RM, Fettiplace MR, Weinberg GL, Vitello JM. Blood Density Is Nearly Equal to Water Density: A Validation Study of the Gravimetric Method of Measuring Intraoperative Blood Loss. J Vet Med. 2015;2015:152730. doi:10.1155/2015/152730
  • 2. Malcherczyk D, Klasan A, Ebbinghaus A, et al. Factors affecting blood loss and blood transfusion in patients with proximal humeral fractures. J Shoulder Elbow Surg. 2019;28(6):e165-e174. doi:10.1016/j.jse.2019.01.018
  • 3. Lei F, Li Z, He W, et al. Hidden blood loss and the risk factors after posterior lumbar fusion surgery: A retrospective study. Medicine (Baltimore). 2020;99(19):e20103. doi:10.1097/MD.0000000000020103
  • 4. Zhou Y, Fu X, Yang M, Ke S, Wang B, Li Z. Hidden blood loss and its possible risk factors in minimally invasive transforaminal lumbar interbody fusion. J Orthop Surg Res. 2020;15(1):445. Published 2020 Sep 29. doi:10.1186/ s13018-020-01971-5
  • 5. Abu-Ghanem Y, Mahajna H, Ghinea R, White I, Inbar R, Avital S. Predictive factors for perioperative blood transfusions in laparoscopic colorectal surgery. Int J Colorec tal Dis. 2014;29(6):723-728. doi:10.1007/s00384-014- 1854-6
  • 6. Abu-Ghanem Y, Dotan Z, Kaver I, Ramon J. Predictive factors for perioperative blood transfusions in partial nephrectomy for renal masses. J Surg Oncol. 2015;112(5):496-502. doi:10.1002/jso.24029
  • 7. Nielsen AW, Helm MC, Kindel T, et al. Perioperative bleeding and blood transfusion are major risk factors for venous thromboembolism following bariatric surgery. Surg Endosc. 2018;32(5):2488-2495. doi:10.1007/s00464- 017-5951-9
  • 8. Susmallian S, Danoch R, Raskin B, Raziel A, Barnea R, Dvora P. Assessing Bleeding Risk in Bariatric Surgeries: A Retrospective Analysis Study. Dig Dis. 2020;38(6):449- 457. doi:10.1159/000506456
  • 9. Chang IH, Byun SS, Hong SK, Lee SE. Assessing the body mass index of patients might help to predict blood loss during radical retropubic prostatectomy in Korean men. BJU Int. 2007;99(3):570-574. doi:10.1111/j.1464- 410X.2006.06637.x
  • 10. Wu YS, Zhang H, Zheng WH, Feng ZH, Chen ZX, Lin Y. Hidden blood loss and the influential factors after percutaneous kyphoplasty surgery. Eur Spine J. 2017;26(7):1878- 1883. doi:10.1007/s00586-017-4950-9
  • 11. Chang IH, Byun SS, Hong SK, Lee SE. Assessing the body mass index of patients might help to predict blood loss during radical retropubic prostatectomy in Korean men. BJU Int. 2007;99(3):570-574. doi:10.1111/j.1464- 410X.2006.06637.x
  • 12. Chang SS, Duong DT, Wells N, Cole EE, Smith JA Jr, Cookson MS. Predicting blood loss and transfusion requirements during radical prostatectomy: the significant negative impact of increasing body mass index. J Urol. 2004;171(5):1861-1865. doi:10.1097/01. ju.0000120441.96995.e3
  • 13. Villavicencio A, Lee Nelson E, Rajpal S, Vivek N, Burneikiene S. The impact of BMI on operating room time, blood loss, and hospital stay in patients undergoing spinal fusion. Clin Neurol Neurosurg. 2019;179:19-22. doi:10.1016/j.clineuro.2019.02.012
  • 14. Lei F, Li Z, He W, et al. Hidden blood loss and the risk factors after posterior lumbar fusion surgery: A retrospective study. Medicine (Baltimore). 2020;99(19):e20103. doi:10.1097/MD.0000000000020103
  • 15. Vincent JL, Moreno R. Clinical review: scoring systems in the critically ill. Crit Care. 2010;14(2):207. doi:10.1186/ cc8204
  • 16. Bath P, Algert C, Chapman N, Neal B; PROGRESS Collaborative Group. Association of mean platelet volume with risk of stroke among 3134 individuals with history of cerebrovascular disease. Stroke. 2004;35(3):622-626. doi:10.1161/01.STR.0000116105.26237.EC
  • 17. Özlü MF, Öztürk S, Ayhan SS, et al. Predictive value of mean platelet volume in young patients with non-STsegment elevation acute coronary syndromes: a retrospective observational study. Anadolu Kardiyol Derg. 2013;13(1):57-61. doi:10.5152/akd.2013.007
  • 18. Huang J, Chen Y, Cai Z, Chen P. Diagnostic value of platelet indexes for pulmonary embolism. Am J Emerg Med. 2015;33(6):760-763. doi:10.1016/j.ajem.2015.02.043
  • 19. Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V. Mean Platelet Volume (MPV): New Perspectives for an Old Marker in the Course and Prognosis of Inflammatory Conditions. Mediators Inflamm. 2019;2019:9213074. Published 2019 Apr 17. doi:10.1155/2019/9213074
  • 20. Cetin M, Bakirci EM, Baysal E, et al. Increased platelet distribution width is associated with ST-segment elevation myocardial infarction and thrombolysis failure. Angiology. 2014;65(8):737-743. doi:10.1177/0003319713520068
  • 21. Cetin MS, Ozcan Cetin EH, Akdi A, et al. Platelet distribution width and plateletcrit: novel biomarkers of ST elevation myocardial infarction in young patients. Kardiol Pol. 2017;75(10):1005-1012. doi:10.5603/KP.a2017.0135
  • 22. Chen SY, Lin YS, Cheng YF, Wang H, Niu XT, Zhang WL. Mean Platelet Volume-To-Lymphocyte Ratio Predicts Poor Functional Outcomes Among Ischemic Stroke Patients Treated With Intravenous Thrombolysis. Front Neurol. 2019;10:1274. Published 2019 Dec 10. doi:10.3389/fneur.2019.01274
  • 23. Ming L, Jiang Z, Ma J, Wang Q, Wu F, Ping J. Platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, and platelet indices in patients with acute deep vein thrombosis. Vasa. 2018;47(2):143-147. doi:10.1024/0301-1526/ a000683
  • 24. Şahin M, Elbey B, Şahin A, Yüksel H, Türkcü FM, Çaça İ. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in retinal vein occlusion. Clin Exp Optom. 2020;103(4):490-494. doi:10.1111/cxo.13008
  • 25. Wang Q, Ma J, Jiang Z, Ming L. Prognostic value of neutrophil- to-lymphocyte ratio and platelet-to-lymphocyte ratio in acute pulmonary embolism: a systematic review and meta-analysis. Int Angiol. 2018;37(1):4-11. doi:10.23736/S0392-9590.17.03848-2
  • 26. Telo S, Kuluöztürk M, Deveci F, Kirkil G. The relationship between platelet-to-lymphocyte ratio and pulmonary embolism severity in acute pulmonary embolism. Int Angiol. 2019;38(1):4-9. doi:10.23736/S0392-9590.18.04028-2
  • 27. Zheng F, Cammisa FP Jr, Sandhu HS, Girardi FP, Khan SN. Factors predicting hospital stay, operative time, blood loss, and transfusion in patients undergoing revision posterior lumbar spine decompression, fusion, and segmental instrumentation. Spine (Phila Pa 1976). 2002;27(8):818-824. doi:10.1097/00007632- 200204150-00008
  • 28. Thompson ME, Kohring JM, McFann K, McNair B, Hansen JK, Miller NH. Predicting excessive hemorrhage in adolescent idiopathic scoliosis patients undergoing posterior spinal instrumentation and fusion. Spine J. 2014;14(8):1392-1398. doi:10.1016/j. spinee.2013.08.022
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Anesteziyoloji
Bölüm Makaleler
Yazarlar

Seliman Çetinbulut 0000-0003-1531-112X

Onur Palabıyık 0000-0003-3876-4279

Havva Kocayigit 0000-0002-8719-7031

Ayça Taş Tuna 0000-0001-6764-2647

Davut Ceylan 0000-0002-2056-2786

Erken Görünüm Tarihi 21 Mart 2024
Yayımlanma Tarihi 31 Mart 2024
Gönderilme Tarihi 17 Ocak 2024
Kabul Tarihi 12 Mart 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 14 Sayı: 1

Kaynak Göster

AMA Çetinbulut S, Palabıyık O, Kocayigit H, Taş Tuna A, Ceylan D. Effectiveness of Platelet Markers ın Estimating the Amount of Intraoperative Bleeding ın Vertebra Surgery. Sakarya Tıp Dergisi. Mart 2024;14(1):89-98. doi:10.31832/smj.1421647
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