Thrombocytopenia Associated with Unrecognized Non-Alcoholic Fatty Liver Disease Is an Independent Predictor of Perioperative Significant Blood Loss in Cervical Laminoplasty

Suzuki, Ryota; Koike, Yoshinao; Ota, Masahiro; Endo, Tsutomu; Hisada, Yuichiro; Tsujimoto, Takeru; Kanayama, Masahiro; Ito, Yoichi M.; Sudo, Hideki; Iwata, Akira; Yamada, Katsuhisa; Iwasaki, Norimasa; Takahata, Masahiko

Thrombocytopenia Associated with Unrecognized Non-Alcoholic Fatty Liver Disease Is an Independent Predictor of Perioperative Significant Blood Loss in Cervical Laminoplasty

Suzuki, Ryota; Koike, Yoshinao; Ota, Masahiro et al.

World neurosurgery, 2021, 155, E797-E804

Permalink : https://hdl.handle.net/2115/83357

このアイテムのアクセス数:427件（2026-10-13 20:06 集計）

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アクセス権	open access
URI	https://hdl.handle.net/2115/83357
タイトル	Thrombocytopenia Associated with Unrecognized Non-Alcoholic Fatty Liver Disease Is an Independent Predictor of Perioperative Significant Blood Loss in Cervical Laminoplasty
著者	Suzuki, Ryota ; Koike, Yoshinao ; Ota, Masahiro ; Endo, Tsutomu ; Hisada, Yuichiro ; Tsujimoto, Takeru ; Kanayama, Masahiro ; Ito, Yoichi M. ; Sudo, Hideki ; Iwata, Akira ; Yamada, Katsuhisa ; Iwasaki, Norimasa ; Takahata, Masahiko
著者名 Suzuki, Ryota
著者名 Koike, Yoshinao
著者名 Ota, Masahiro
著者名 Endo, Tsutomu
著者名 Hisada, Yuichiro
著者名 Tsujimoto, Takeru
著者名 Kanayama, Masahiro
著者名 Ito, Yoichi M.
著者名 Sudo, Hideki
著者名 Iwata, Akira
著者名 Yamada, Katsuhisa
e-Rad_Researcher 30322803 著者名 Iwasaki, Norimasa
e-Rad_Researcher 40374368 著者名 Takahata, Masahiko
言語	英語
キーワード	Cervical laminoplasty
	Hematoma
	Liver fibrosis
	Non-alcoholic fatty liver disease
	Ossification of the posterior longitudinal ligament
	Significant blood loss
	Thrombocytopenia
発行日	2021-11
出版者	Elsevier
収録物名	World neurosurgery
巻(号)	155
ページ	E797-E804
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Version of Record
PISSN	1878-8750
関連情報 (isIdenticalTo)	出版社版DOI https://doi.org/10.1016/j.wneu.2021.09.012