Title: | Thrombocytopenia Associated with Unrecognized Non-Alcoholic Fatty Liver Disease Is an Independent Predictor of Perioperative Significant Blood Loss in Cervical Laminoplasty |
Authors: | Suzuki, Ryota Browse this author |
Koike, Yoshinao Browse this author |
Ota, Masahiro Browse this author |
Endo, Tsutomu Browse this author |
Hisada, Yuichiro Browse this author |
Tsujimoto, Takeru Browse this author |
Kanayama, Masahiro Browse this author |
Ito, Yoichi M. Browse this author |
Sudo, Hideki Browse this author |
Iwata, Akira Browse this author |
Yamada, Katsuhisa Browse this author |
Iwasaki, Norimasa Browse this author →KAKEN DB |
Takahata, Masahiko Browse this author →KAKEN DB |
Keywords: | Cervical laminoplasty |
Hematoma |
Liver fibrosis |
Non-alcoholic fatty liver disease |
Ossification of the posterior longitudinal ligament |
Significant blood loss |
Thrombocytopenia |
Issue Date: | Nov-2021 |
Publisher: | Elsevier |
Journal Title: | World neurosurgery |
Volume: | 155 |
Start Page: | E797 |
End Page: | E804 |
Publisher DOI: | 10.1016/j.wneu.2021.09.012 |
Abstract: | OBJECTIVE: To identify risk factors for significant blood loss (SBL) in cervical laminoplasty, especially regarding thrombocytopenia and coagulopathy resulting from nonalcoholic fatty liver disease (NAFLD). METHODS: We retrospectively investigated differences in patient background data, laboratory data at the time of admission, and surgery-related data of 317 patients who underwent cervical laminoplasty and were divided into SBL (estimated blood loss [EBL] + drainage [D] 2500 g) and non-SBL (EBL + D < 500 g) groups. To evaluate liver status, we used the fibrous 4 index and considered fibrous 4 index >= 1.85 as a representative phenotype for NAFLD with liver fibrosis. In addition, the risk factor for perioperative SBL was investigated using multiple logistic regression analysis, and the cutoff value was calculated. RESULTS: Incidence of perioperative SBL in cervical laminoplasty was 7.3% (23/317). Compared with the non-SBL group, the SBL group demonstrated significantly lower platelet count (PIT), lower aspartate aminotransferase, longer operation time, and greater number of opened laminae. According to multivariate analysis, lower PLT and a greater number of opened laminae were identified as significant risk factors for perioperative SBL. The cutoff value of PLT for predicting SBL was determined to be 16.7 x 10(4)/mu L using a receiver operating characteristic curve. The liver fibrosis group revealed significantly lower PLT and greater EBL + D than the non-liver fibrosis group. CONCLUSIONS: Thrombocytopenia is an independent predictor of perioperative SBL in cervical laminoplasty. Thus, patients with mild thrombocytopenia that may be associated with NAFLD must be carefully monitored to avoid perioperative SBL. |
Type: | article |
URI: | http://hdl.handle.net/2115/83357 |
Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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