Diagnostic blood loss in the patient undergoing head and neck surgery.
OBJECTIVE
To examine retrospectively the amount of blood lost solely for diagnostic purposes in a defined group of patients.


METHODS
Retrospective medical chart review of a case series.


METHODS
Operating theater and surgical intensive care unit in a major tertiary care center.


METHODS
Thirty-nine consecutive patients with head and neck cancer undergoing major surgical procedures and requiring overnight intensive care unit monitoring.


METHODS
Patient medical records were analyzed for procedure, starting hematocrit reading, intraoperative estimated blood loss and intravenous fluids, operative time, history of blood product transfusion, blood lost for each phlebotomy encounter, and the immediate cost therefrom.


RESULTS
The mean diagnostic blood loss was 181 mL, which was 36% of estimated blood loss. In the group of 23 nontransfused patients, the average drop in hematocrit was 9.7%. This change in hematocrit correlated most strongly with operating time (P < .02) and the amount of intraoperative intravenous fluid administration (P < .05). The average cost to the patient directly from phlebotomy-associated charges was $542.


CONCLUSIONS
Diagnostic blood loss contributes significantly to the overall blood loss in the patient undergoing head and neck surgery.
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, Md.
J C
JC
Borders
D W
DW
Eisele
C A
CA
Lyles
D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D001803:Blood Transfusion / Q000706:statistics & numerical data; D001810:Blood Volume; D001815:Bloodletting / Q000191:economics; D005249:Fees and Charges; D005260:Female; D005440:Fluid Therapy; D006258:Head and Neck Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000601:surgery*; D006400:Hematocrit; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D012189:Retrospective Studies; D013997:Time Factors