(HealthDay News) – For patients undergoing scoliosis surgery, the risk of massive blood loss is increased with preoperative Cobb angles >50 degrees and for those undergoing osteotomy or fusion of >6 levels, according to a study published in the Feb. 15 issue of Spine.

Xuerong Yu, MD, from Peking Union Medical College Hospital in Beijing, and colleagues retrospectively analyzed data from patients undergoing scoliosis surgery, from June 1, 2011 to Oct. 31, 2011, based on their classification as having lost >30% of estimated blood volume (group A; 95 patients) and those who lost ≤30% of their blood volume (group B; 64 patients). Total blood loss was defined as the sum of intraoperative and postoperative estimated blood loss.

The researchers found that 59.7% of the patients had massive blood loss. There were significant differences between the groups with patients in group A shorter, with larger preoperative Cobb angles, more levels fused, and more osteotomies than patients in group B. Independent risk factors for massive blood loss included preoperative Cobb angle of >50 degrees (odds ratio [OR], 2.47), >6 levels fused (OR, 3.7), and osteotomy (OR, 4.64).

“In conclusion, patients with preoperative Cobb angle larger than 50 degrees or patients planning to undergo osteotomy or fusion of more than six levels have an increased risk of massive blood loss,” write the authors. “This may contribute to an improved use of blood conservation strategy.”

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