Are preoperative hematologic parameters predictive of intraoperative bleeding in orthognathic surgery?

Abstract

Aim: Orthognathic surgery is performed to correct dentofacial abnormalities and is generally known as a safe procedure with minimal bleeding. The purpose of this study was to evaluate whether the preoperative hematological parameters help predict intraoperative bleeding in orthognathic surgery.

Material and Methods: This retrospective study was performed with patients who underwent orthognathic surgery. Patients records were evaluated in terms of the demographics (gender, age, weight), duration of the surgery, amount of intraoperative bleeding, and the preoperatively routine complete blood count (CBC) parameters, especially PLT, MPV, MPV/PLT ratio, coagulation tests (PT, a PTT, INR) and NLR were recorded from patient files.

Results: The study included 101 patients with a mean age of 21.7 +/- 4.8 years. The female to mate ratio was 1.1 (52/49). The median duration of the operation was 270 minutes, ranging from 155 to 420 minutes. The amount of blood loss ranged from 90 to 820 ml in all subjects, with a median of 230 ml. The preoperative median hemoglobin value was 14.4 g/dL PT, INR, aPTT, and weight were not independent predictors for the amount of bleeding. However, the duration of the surgery was an independent predictor for the amount of bleeding (p<0.001). There was no correlation between the MPV/PLT ratio (r=0.003, p=0.972) and the neutrophil-to-lymphocyte ratio (NLR) (r--0.008, p=0.935) with the amount of bleeding (ml).

Discussion: Improving possible objective markers to predict intraoperative bleeding amounts is important for avoiding and managing the intraoperative bleeding complications for the surgery team in maxillofacial surgery. The results of this study demonstrated no correlation between preoperative hematologic normal ranged parameters such as PLT, MPV, MPV/PLT, NLR, PT, PTT, INR, and intraoperative bleeding in orthognathic surgery. Thus, caution in the preparation of patients and standardized preoperative procedures are essential to avoid undesirable intraoperative bleeding in orthognathic surgery.