Comparison of the Error Rates of an Anesthesiologist and Surgeon in Estimating Perioperative Blood Loss in Major Orthopedic Surgeries: Clinical Observational Study

Abstract

Objective: Since the anesthesiologist and surgeon have different observation angles in the intraoperative period, their predictions based on clinical observation vary greatly. Whether these predictions accurately reflect actual blood loss is still a matter of debate. The aim of this study was to compare the clinical observations of anesthesiologists and surgeons on perioperative blood loss and transfusion requirements with laboratory results. Methods: Sixty patients who were scheduled for major orthopedic surgery were included in the study. Same anesthesiologist and the same surgeon were asked to estimate the amount of blood loss, and whether blood transfusion was needed during the perioperative period. The amount of blood loss was calculated synchronously using the perioperative hemoglobin value and the total blood volume. The blood loss estimates of the anesthesiologist and the surgeon were compared, with blood loss calculated in the laboratory. Results: The anesthesiologist's and the surgeon's estimates of perioperative mean blood loss volume were found to be lower than the blood volume calculated in the laboratory (p=0.01). When the estimated blood loss was less than 600 mL, it was considered as overestimation, and when it was more than 600 mL then it was interpreted as 20% underestimation (p=0.01). According to our findings, the rate of error in the perioperative blood loss estimates was 28.72%. When the blood loss was more than 1000 mL, the error rate of predictions was 34.03%; when it was less than 1000 mL, the error rate of predictions was 25.18%. Conclusion: We believe that when blood loss is more than 1000 mL in major orthopedic surgeries, the error in the estimation is increased, the amount of blood loss is difficult to predict, and the anesthesiologist makes a better prediction than the surgeon. © Copyright Anesthesiology and Reanimation Specialists' Society.