Hidden blood loss and its risk factors after hip reconstruction in children

Abstract

Abstract Objective: There were few reports in the literature about the hidden blood loss (HBL) after modified Pemberton osteotomy(PO) for children. To evaluate HBL and its risk factors among children following PO for Developmental Dysplasia of the Hip(DDH). Methods: A retrospective analysis was made on the clinical data of 42 patients(58 hips) underwent PO surgery from March 2020 to March 2023. Serial complete blood count assays were performed consecutively on the day of admission and 4 days after surgery. Recording preoperative and postoperative hematocrit to calculate HBL according to Gross formula and analyzing its related factors. Pearson correlations, Spearman correlations and multivariate liner analysis were used to find association between patient characteristics and HBL. Result:The mean HBL was 278.06±291.00 mL, accounting for 67.17% of total blood loss. It indicated that the amount of HBL was much higher than we expected. According to the model of multiple linear regression analysis, Patient weight(P＜0.001), surgical duration(P＜0.001) were independent risk factors contributing to the HBL. Conclusions:HBL following PO for DDH was significant and should be recognised as a detrimental factor to patient safety during the perioperative period, especially in patients with high weight and long surgical duration. Level of evidence: III