Evidence map›Paper›PMID 37314503›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2024

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

Natalie L Zusman, Danielle F Peterson, Michelle M Lawson, Natasha S McKibben, David M Gallacher, Darin M Friess, Zachary M Working

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

7 authors.

Natalie L ZusmanDepartment of Orthopaedics and Rehabilitation, Oregon Health and Science University, Sam Jackson Hall, Suite 2360, Portland, OR, 97239, USA.
Danielle F PetersonDepartment of Orthopaedics and Rehabilitation, Oregon Health and Science University, Sam Jackson Hall, Suite 2360, Portland, OR, 97239, USA.
Michelle M LawsonDepartment of Orthopaedics and Rehabilitation, Oregon Health and Science University, Sam Jackson Hall, Suite 2360, Portland, OR, 97239, USA.
Natasha S McKibbenDepartment of Orthopaedics and Rehabilitation, Oregon Health and Science University, Sam Jackson Hall, Suite 2360, Portland, OR, 97239, USA.
David M GallacherDepartment of Orthopaedics and Rehabilitation, Oregon Health and Science University, Sam Jackson Hall, Suite 2360, Portland, OR, 97239, USA.
Darin M FriessDepartment of Orthopaedics and Rehabilitation, Oregon Health and Science University, Sam Jackson Hall, Suite 2360, Portland, OR, 97239, USA.
Zachary M WorkingDepartment of Orthopaedics and Rehabilitation, Oregon Health and Science University, Sam Jackson Hall, Suite 2360, Portland, OR, 97239, USA. workingz@ohsu.edu.ORCID http://orcid.org/0000-0003-1768-1001

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe 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.

methodsAll 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.

results371 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).

conclusionsRadiographic bladder shift is an easily available visual marker, in patients sustaining acetabular fractures, that may predict intraoperative hemorrhage and need for transfusions.

Indexed as

AcetabulumBlood Loss, SurgicalFractures, BoneUrinary BladderAdultBlood TransfusionFemaleFracture Fixation, InternalHumansMaleMiddle AgedRadiographyRetrospective StudiesAcetabular fractureAcute trauma careBladder shiftIntraoperative blood lossOrthopaedic traumaPelvic fracture

Identifiers

PMID37314503

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.