Daniel M Sciubba1,2, Nitin Khanna3, Zach Pennington4,5, Rahul K Singh6. 1. Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA dsciubba1@northwell.edu. 2. Department of Neurosurgery, Zucker School of Medicine at Hofstra, Long Island Jewish Medical Center and North Shore University Hospital, Northwell Health, Manhasset, NY, USA. 3. Department of Orthopedics, Indiana University School of Medicine, Munster, USA. 4. Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 5. Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA. 6. Baxter Healthcare Corporation, Deerfield, IL, USA.
Abstract
BACKGROUND: The Validated Intraoperative Bleeding Scale (VIBe Scale) was initially validated with surgeons who operate on cardiothoracic, abdominal, and pelvic cavities and fulfilled criteria for a clinician-reported scale. However, there is a need for a tool to aid in intraoperative blood management during spine surgeries. The purpose of the present study was to establish the reliability and consistency of the VIBe Scale as a tool for spine surgeons to assess intraoperative bleeding. METHODS: Orthopedic (n = 16) and neurological (n = 9) spine surgeons scored videos depicting surgical bleeding and assessed the VIBe Scale's relevance and clarity. Inter- and intraobserver agreement (Kendall's W) were calculated for all surgeons and pooled with responses from the original study to establish agreement across specialties. RESULTS: All of the spine surgeons indicated that the scale was clinically relevant for evaluating hemostasis and could be implemented in a clinical study. Twenty-two spine surgeons (88%) reported that the scale represents the range of bleeding site sizes and severities expected in their practice. Twenty-four spine surgeons (96%) indicated that the scale would be useful in communicating bleeding severity with other members of the surgical team. Interobserver agreement was acceptable (0.79) for orthopedic specialists, appreciable (0.88) for neurological specialists, and appreciable (0.88) for the combined specialists. Intraobserver agreement was excellent for orthopedic (0.91) and neurological (0.91) spine surgeons and excellent (0.96) for the combined specialists. CONCLUSIONS: The results highlight the reliability of the VIBe Scale and potential utility for quantifying intraoperative blood loss in spine surgery. CLINICAL RELEVANCE: The VIBe Scale may be useful for evaluating the efficacy of untested intraoperative hemostatic agents and for comparing the relative efficacy of 2 or more analogous agents. It may also prove useful for intraoperative staff by quantifying ongoing intraoperative blood loss and correlating losses with the potential transfusion and intraoperative hemostatic agent requirements. This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery.
BACKGROUND: The Validated Intraoperative Bleeding Scale (VIBe Scale) was initially validated with surgeons who operate on cardiothoracic, abdominal, and pelvic cavities and fulfilled criteria for a clinician-reported scale. However, there is a need for a tool to aid in intraoperative blood management during spine surgeries. The purpose of the present study was to establish the reliability and consistency of the VIBe Scale as a tool for spine surgeons to assess intraoperative bleeding. METHODS: Orthopedic (n = 16) and neurological (n = 9) spine surgeons scored videos depicting surgical bleeding and assessed the VIBe Scale's relevance and clarity. Inter- and intraobserver agreement (Kendall's W) were calculated for all surgeons and pooled with responses from the original study to establish agreement across specialties. RESULTS: All of the spine surgeons indicated that the scale was clinically relevant for evaluating hemostasis and could be implemented in a clinical study. Twenty-two spine surgeons (88%) reported that the scale represents the range of bleeding site sizes and severities expected in their practice. Twenty-four spine surgeons (96%) indicated that the scale would be useful in communicating bleeding severity with other members of the surgical team. Interobserver agreement was acceptable (0.79) for orthopedic specialists, appreciable (0.88) for neurological specialists, and appreciable (0.88) for the combined specialists. Intraobserver agreement was excellent for orthopedic (0.91) and neurological (0.91) spine surgeons and excellent (0.96) for the combined specialists. CONCLUSIONS: The results highlight the reliability of the VIBe Scale and potential utility for quantifying intraoperative blood loss in spine surgery. CLINICAL RELEVANCE: The VIBe Scale may be useful for evaluating the efficacy of untested intraoperative hemostatic agents and for comparing the relative efficacy of 2 or more analogous agents. It may also prove useful for intraoperative staff by quantifying ongoing intraoperative blood loss and correlating losses with the potential transfusion and intraoperative hemostatic agent requirements. This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery.
Authors: Kevin M Lewis; Qing Li; Drew S Jones; JoMichelle D Corrales; Hongyan Du; Philippe E Spiess; Emanuele Lo Menzo; Abe DeAnda Journal: Surgery Date: 2016-11-10 Impact factor: 3.982
Authors: Laurent G Glance; Andrew W Dick; Dana B Mukamel; Fergal J Fleming; Raymond A Zollo; Richard Wissler; Rabih Salloum; U Wayne Meredith; Turner M Osler Journal: Anesthesiology Date: 2011-02 Impact factor: 7.892
Authors: Alexander J Spanjersberg; Jan Paul Ottervanger; Arno P Nierich; Ron G H Speekenbrink; Wim Stooker; Marga Hoogendoorn; Dennis van Veghel; Saskia Houterman; George J Brandon Bravo Bruinsma Journal: J Thorac Cardiovasc Surg Date: 2019-08-28 Impact factor: 5.209
Authors: Eefje N de Vries; Hubert A Prins; Rogier M P H Crolla; Adriaan J den Outer; George van Andel; Sven H van Helden; Wolfgang S Schlack; M Agnès van Putten; Dirk J Gouma; Marcel G W Dijkgraaf; Susanne M Smorenburg; Marja A Boermeester Journal: N Engl J Med Date: 2010-11-11 Impact factor: 91.245
Authors: Christian Fisahn; Cameron Schmidt; Josh E Schroeder; Emiliano Vialle; Isador H Lieberman; Joseph R Dettori; Thomas A Schildhauer Journal: Global Spine J Date: 2018-02-09
Authors: Daniel J Del Gaizo; William D Spotnitz; Rachel W Hoffman; Mark Christopher Hermann; Linda S Sher; Russell H Spotnitz; Yuri S Genyk; Ian J Schorn; Daniel L Gillen; Bobby L White; Bruce G Miller; Roberto J Manson Journal: Clin Appl Thromb Hemost Date: 2020 Jan-Dec Impact factor: 2.389