Pre-Operative and Post-Operative Risk Factors in the Assessment of Intensive Care Necessity after Scoliosis Surgery

Corrective surgeries for scoliosis are usually long surgeries due to the involvement of multiple vertebrae. Extended surgical time, increased number of vertebrae fused and potential blood loss may require infusion of high volumes of fluid and blood products and may require intensive care postoperatively. Our study retrospectively analysed medical files of a total 155 patients that had scoliosis correction surgery under general anesthesia at our institute between 2013-2015. Among 155 patients , 25 patients needed intensive care after scoliosis surgery. Considering the characteristics of the patients that required intensive care, ASA II (American Society of Anaesthesiologists), Cobb angle>60° and neuromuscular type scoliosis were identified as preoperative risk factors (p=0.000, p=0.011, p=0.000 respectively). Prolonged anesthesia and surgery, surgical blood loss and increased volüme of blood product transfusion, which were caused by elevated number of vertebrae fused, were detected to be intraoperative risk factors in the patients requiring intensive care (p=0.000, p=0.000, p=0.000, p=0.006, p=0.000, respectively). It was also determined that hypothermia and acidosis induced by extended surgical duration and increased transfusion raised intensive care requirement (p=0.001, p=0.000, respectively). It may be possible to contribute to the management of intensive care resources if patients who may need intensive care can be predicted by taking preoperative and intraoperative risk factors into consideration