To analyse the perioperative hidden blood loss and its influencing factors in elderly patients with osteoporotic vertebral compression fracture (OVCF) treated by percutaneous vertebroplasty (PVP).

From September 2018 to December 2018, 91 OVCF patients treated with PVP were selected. The patient's height, weight, duration of symptoms, previous medical history and other basic information were routinely record. The hemoglobin (Hb) and hematocrit (Hct) immediately after admission and the next day postoperative were recorded. The operation time, intraoperative blood loss, preoperative and postoperative vertebral height, and bone cement leakage were recorded. The total blood loss was calculated according to the Gross's formula, and then the hidden blood loss (HBL) was calculated based on the total blood loss and the visible blood loss. The statistical analysis of the difference of the patients' hidden blood loss was performed, and then influential factors were further analyzed by multivariate linear regression analysis and t test.

The mean visible blood loss was (12±5) ml and hidden blood loss was (294±192) ml, the differences between the visible and hidden blood loss was statistically significant (P=0.000). According to the multiple linear regression analysis, fresh fracture and short duration of symptoms (P=0.024), the number of surgical segment (P=0.010), operation time (P=0.013), loss of vertebral height (P=0.037), recovery of vertebral height (P=0.003), and bone cement leakage (P=0.005) increased the amount of HBL. The gender (P=0.193), age (P=0.607), BMI (P=0.913), hypertension (P=0.539), diabetes (P=0.903), fracture site (P=0.768), and intraoperative blood loss (P=0.715) had no correlation with the amount of HBL.

There is obvious HBL during the perioperative period of PVP in elderly OVCF patients. Fresh fractures, multi-segment vertebral fractures, longer operation time, loss of vertebral height, better recovery of vertebral height and bone cement leakage increased perioperative hidden blood loss during PVP.