Evaluation of

Farzi, F; Mirmansouri, A; Haryalchi, K; Biazar, G; Fakor, F; Atrkar Roshan, Z; Jannati, E

Evaluation of "the Visual Scale Estimation" Diagnostic Accuracy in Determination of the Blood Loss Volume during Abdominal Hysterectomy Compared with Hemoglobin and Hematocrit Alterations before and after Surgery

Document Type : Original Article

Authors

F Farzi

A Mirmansouri

K Haryalchi

G Biazar

F Fakor

Z Atrkar Roshan

E Jannati

Associate Professor of Anesthesia, Gilan University of Medical Sciences and Health Services, Velayat Hospital, Gilan, Iran

Abstract

Introduction & Objective: Intraoperative hemorrhage is one of the most common complications of abdominal hysterectomy. Various methods are used to estimate the amount of blood loss, visual scale estimation is one of them. Of course blood loss estimation based on changes in hematocrit or hemoglobin levels have greater accuracy but it is a retrospective method not a clinical method. The aim of the present study was to evaluate "the visual scale estimation" diagnostic accuracy in determination of the blood loss volume during abdominal hysterectomy compared with hemoglobin and hematocrit alterations before and after surgery. Materials & Methods: In this study 74 cases of abdominal hysterectomy were evaluated in the training Al Zahra Hospital in Rasht. Intraoperative blood loss was assessed in two ways: visual estimation (based on the volume of blood in the suction device, the number of blood gauze pads accumulated during the procedure and blood loss at the operation sites and Surgical Drapes) and the other way was comparing hemoglobin and hematocrit before and 12 hours after surgery. The results of the two methods were analyzed by statistical tests (sensitivity, specify, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value, Cohen's kappa cofficient &…) using SPSS version 21 for calculating the diagnostic value of visual Scale estimation. Results: In examining the convergence of bleeding by using Cohen's kappa coefficient a moderate agreement was found between Visual estimation and hemoglobin changes (kappa = 0.497, P

Keywords

Visual Scale Estimation

Hysterectomy Intraoperative Hemorrhage

Hemoglobin and Hematocrit Alterations