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Radiographic bladder shift is a harbinger of intraoperative blood loss in acetabular surgical fixation.
Zusman, Natalie L; Peterson, Danielle F; Lawson, Michelle M; McKibben, Natasha S; Gallacher, David M; Friess, Darin M; Working, Zachary M.
Afiliación
  • Zusman NL; Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Sam Jackson Hall, Suite 2360, Portland, OR, 97239, USA.
  • Peterson DF; Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Sam Jackson Hall, Suite 2360, Portland, OR, 97239, USA.
  • Lawson MM; Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Sam Jackson Hall, Suite 2360, Portland, OR, 97239, USA.
  • McKibben NS; Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Sam Jackson Hall, Suite 2360, Portland, OR, 97239, USA.
  • Gallacher DM; Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Sam Jackson Hall, Suite 2360, Portland, OR, 97239, USA.
  • Friess DM; Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Sam Jackson Hall, Suite 2360, Portland, OR, 97239, USA.
  • Working ZM; Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Sam Jackson Hall, Suite 2360, Portland, OR, 97239, USA. workingz@ohsu.edu.
Eur J Orthop Surg Traumatol ; 2023 Jun 14.
Article en En | MEDLINE | ID: mdl-37314503
PURPOSE: The purpose of this study was to characterize the relationship between a novel radiographic measurement on initial AP pelvis radiograph (termed "bladder shift," BS) to intraoperative blood loss (IBL) during acetabular surgical fixation. METHODS: All adult patients receiving unilateral acetabular fixation (Level 1 academic trauma; 2008-18) were reviewed. AP pelvis radiographs were reviewed for visible bladder outlines and then measured to determine the percentage deformation toward the midline. Hemoglobin & hematocrit data were then used to calculate quantitative blood loss between pre- and post- operative blood counts for data analysis. RESULTS: 371 patients with unilateral traumatic acetabular fractures requiring fixation were reviewed; 99 of these had visible bladder outlines, complete blood count and transfusion data (2008-2018; 66% associated patterns). Median bladder shift (BS) was 13.3%. Every 10% of bladder shift was associated with 123 mL greater IBL. Patients with full bladder shift to midline sustained a median 1.5L IBL (interquartile range [IQR] 0.8 to 1.6). Associated patterns had a threefold greater median BS (associated: 16.5% [15.4 to 45.9] vs. elementary: 5.6% [1.1 to 15.4], p < 0.05) and received intraoperative pRBC twice as frequently (57% vs. 24%, p < 0.01). CONCLUSIONS: Radiographic bladder shift is an easily available visual marker, in patients sustaining acetabular fractures, that may predict intraoperative hemorrhage and need for transfusions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur J Orthop Surg Traumatol Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Francia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur J Orthop Surg Traumatol Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Francia