Preoperative coagulopathy and blood transfusion requirements in children with intraventricular lesions undergoing neurosurgery: a retrospective cohort study

Purpose: Pediatric patients undergoing neurosurgery pose risk of perioperative hemorrhage and clotting dysfunction which is increased in tumors with high vascularity, endothelial exposure, and necrosis. Lesions affecting the ventricular system may arise from several etiologies, including rare tumors. The present study aimed to study the preoperative coagulation and transfusion profile of pediatric patients undergoing neurosurgery for intraventricular lesions.

Methods: A retrospective study of all paediatric patients who underwent surgery for intraventricular lesion was included from June 2014 to June 2022. Demographic data, preoperative and postoperative investigations, intraoperative blood loss, blood product transfusion, and duration of surgery were noted. Postoperative outcomes were also assessed.

Results: A total of 98 patients underwent surgery, the median age was 11.1 years (1.0 to 17.0), with a male predominance (50.9%). The median blood loss during surgery was 500 mL (300-812.5). The incidence of preoperative coagulopathy was 30.7%. The intraoperative packed blood cell and fresh frozen plasma transfusion requirement was noted in 50.9% and 5%, respectively. The median ICU stay and hospital stay was 6 days (3-10) and 14 days (4-77), respectively. The mortality rate in the study population was 7.7%.

Conclusion: This study highlights the multifactorial nature of perioperative blood loss and transfusion requirements in pediatric patients undergoing surgery for intraventricular lesions. Factors such as tumor histopathology, preoperative hemoglobin levels, and surgical duration play a crucial role in determining transfusion needs.