ArticleJournal of blood medicine2026
Evaluation of Determinants of Intraoperative Blood Loss During Craniotomy for Brain Tumors: A Retrospective Single-Center Cohort Study.
Article in Journal of blood medicine, 2026. 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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Abstract
Background: Inefficient blood product management in craniotomy for tumor removal poses clinical and economic burdens. This study evaluates predictive factors for significant intraoperative blood loss to establish a robust perioperative risk stratification model. Materials and Methods: This retrospective cohort study examined adults undergoing elective brain tumor resections between 2020 and 2024 at a national tertiary referral center. Our primary outcome was significant blood loss, defined as an estimated loss of at least 20% of the patient's total blood volume (EBV). Independent predictors were evaluated using multivariate logistic regression, specifically backward-elimination methods. Results: Out of 378 patients, 35% of patients experienced significant intraoperative blood loss. Bivariate analysis showed female gender, meningioma pathology, cerebral sinus involvement, tumor size ≥ 5 cm, and operation time ≥ 300 minutes associated with higher blood loss (p < 0.05). In the final multivariate model, tumor size ≥ 5 cm was the primary independent predictor (adjusted Odds Ratio [aOR] = 2.736; 95% Confidence Interval [CI]: 1.746-4.285; p < 0.001), followed by meningioma pathology (aOR = 2.104; 95% CI: 1.292-3.426; p = 0.003). Operation time ≥ 300 minutes in the final model (aOR = 1.703) was retained due to its clinical relevance in the operating room. Conclusion: Tumor size ≥ 5 cm and meningioma pathology were independently associated with significant intraoperative blood loss. Utilizing these factors as a preoperative screening tool allows clinical teams to anticipate significant blood loss, optimize cross-matching, and reduce institutional resource wastage.
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