The factors related to blood loss during endoscopic sinus surgery.

Abstract

Abstract Background: The safety and efficacy of endoscopic sinus surgery have improved with the development of new equipment and improved surgical techniques. However, it is accompanied by the risk of complications. Intra-operative blood loss is an important factor for the safe conduct of surgery. Therefore, we examined the factors associated with intra-operative blood loss. Method: The amount of intra-operative bleeding experienced by 518 patients with sinonasal disease who underwent endoscopic sinus surgery under general anaesthesia at our hospital over 9 years was tabulated. Thirty-four variables were extracted after analysis of the patients’ background, sinonasal pathology, and haematology results. Multivariate linear regression analysis was performed. Results: Multivariate analysis revealed significant differences in the prothrombin time-international normalised ratio (PT-INR), Lund-Mackay score, operative time, and initial versus repeat surgery. The degree of change between the 25% and 75% points was significant for the following variables: an increase from 5 to 14 points for the Lund-Mackay score at 73.0 mL. Conclusions: Preoperative precautionary measures should be implemented in the event of re-operation, expected prolonged operative time, high Lund-Mackay score, and prolonged PT-INR. Intra-operative blood loss in patients with a high Lund-Mackay score requires meticulous attention.