Radiographic bladder shift is a harbinger of intraoperative blood loss in acetabular surgical fixation

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 acetabu...

Full description

Saved in:
Bibliographic Details
Published in:European journal of orthopaedic surgery & traumatology 2024-10, Vol.34 (7), p.3447-3453
Main Authors: Zusman, Natalie L., Peterson, Danielle F., Lawson, Michelle M., McKibben, Natasha S., Gallacher, David M., Friess, Darin M., Working, Zachary M.
Format: Article
Language:English
Subjects:
Acetabulum - diagnostic imaging
Acetabulum - injuries
Acetabulum - surgery
Adult
Bladder
Blood Loss, Surgical
Blood Transfusion - statistics & numerical data
Female
Fracture Fixation, Internal - adverse effects
Fracture Fixation, Internal - methods
Fractures, Bone - diagnostic imaging
Fractures, Bone - surgery
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Original Article
Radiography - methods
Retrospective Studies
Surgical Orthopedics
Traumatic Surgery
Urinary Bladder - diagnostic imaging
Urinary Bladder - injuries
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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  
ISSN:1432-1068
1633-8065
1432-1068
DOI:10.1007/s00590-023-03617-8