Is the ABO Blood Group Associated With Increased Intraoperative Blood Loss in Cervical Surgery? A Cohort Study

Abstract ObjectiveTo find out if the ABO blood group is associated with increased intraoperative blood loss in cervical surgery.MethodsA total of 126 patients who underwent cervical surgery under general anesthesia were included in this comparative study. Types of cervical surgery included anterior cervical corpectomy decompression and fusion (ACCF) and anterior cervical discectomy and fusion (ACDF). According to ABO blood group differences, the patients were divided into O and non-O blood groups. Intraoperative blood loss was assessed by external blood loss (EBL), Drop-Hct (hematocrit), and Drop-Hb (hemoglobin). This study collected indicators such as ABO blood group, preop Hct, preop Hb, postop Hct, postop Hb, history of hypertension, and etiology.ResultsThere were 22 patients in the O blood group and 104 in the non-O group. There were no significant differences in age between the two groups. Patients of blood group O showed a significantly higher Drop-Hb than in the non-O group (15(11.9-20.2) g/L and 8.5(6.5-11.0) g/L, p=0.001). Drop-Hct also showed a significant difference between the two groups (4.8 (3.3-6.9) (%) vs. 2.2 (1.6-2.8) (%), p=0.001). There was no association between group O and EBL (p=0.263). The ACCF subgroup included 54 patients. Patients with O blood had significantly higher Drop-Hct and Drop-Hb (p<0.05). In the ACDF subgroup (n=72), Drop-Hct and Drop-Hb of O blood patients increased significantly (p<0.05). ConclusionThe ABO blood group was associated with Drop-Hct and Drop-Hb. Consequently, blood group O may be a risk factor for increased intraoperative blood loss during anterior cervical surgery.