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Grade Visual Presentation Anatomical Appearance Qualitative Description Visually Estimated Rate of Blood Loss (mL/min) 0 No bleeding No bleeding No bleeding ≤1.0 1 Intermittent flow or continuous ooze Capillary-like bleeding Mild >1.0–5.0 2 Continuous flow Venule- and arteriolar-like bleeding Moderate >5.0–10.0 3 Controllable spurting and/or overwhelming flow Noncentral venous- and arterial-like bleeding Severe >10.0–50.0 4 Uncontrollable spurting or gush Central arterial- or venous-like bleeding Life-threateninga >50.0 ↵a Systemic resuscitation is required (eg, volume expanders, vasopressors, blood products, etc).
Participant Background n % Use of hemostatic agents in practice Yes 25 100 No 0 0 Anatomical focus Cervical, lumbar 5 20 Cervical, thoracic, lumbar 6 24 Cervical, thoracic, lumbar, sacral 10 40 Lumbar 2 8 Thoracic, lumbar 1 4 Thoracic, lumbar, sacral 1 4 Surgical specialty Neurological 6 24 Orthopedic 19 76 Surgical subspecialty Deformity 1 4 Deformity, degenerative 1 4 Deformity, degenerative, minimally invasive 8 32 Deformity, degenerative, minimally invasive, trauma 5 20 Deformity, degenerative, minimally invasive, tumor 1 4 Deformity, tumor 1 4 Degenerative 2 8 Degenerative, minimally invasive 3 12 Degenerative, minimally invasive, trauma 1 4 Degenerative, minimally invasive, trauma, tumor 1 4 Degenerative, trauma 1 4 Practice setting Academic 6 24 Academic, nonprofit 2 8 Academic, private 3 12 Nonprofit 4 16 Private 9 36 Private, nonprofit 1 4 - Table 3
Spine surgeon Validated Intraoperative Bleeding Scale responses and associated video bleeding rate.
Specialty Video Bleeding Rate, mL/min VIBe Scale Response, n (%) 0 1 2 3 4 Orthopedic 0.2 13 (68.42) 5 (26.32) 1 (5.26) 0 0 0.7 14 (73.68) 4 (21.05) 0 1 (5.26) 0 1.3 0 10 (52.63) 9 (47.37) 0 0 1.6 2 (10.53) 16 (84.21) 1 (5.26) 0 0 6.4 0 3 (15.79) 14 (73.68) 2 (10.53) 0 7.3 0 11 (57.89) 6 (31.58) 2 (10.53) 0 9.7 0 0 6 (31.58) 13 (68.42) 0 11.4 0 0 0 12 (63.16) 7 (36.84) 27 0 2 (10.53) 12 (63.16) 5 (26.32) 0 38.7 1 (5.26) 2 (10.53) 7 (36.84) 9 (47.37) 0 142.4 0 0 8 (42.11) 8 (42.11) 3 (15.79) 366.7 0 0 0 4 (21.05) 15 (78.95) Neurological 0.2 6 (100.00) 0 0 0 0 0.7 5 (83.33) 0 1 (16.67) 0 0 1.3 0 3 (50.00) 3 (50.00) 0 0 1.6 1 (16.67) 5 (83.33) 0 0 0 6.4 0 1 (16.67) 3 (50.00) 2 (33.33) 0 7.3 0 5 (83.33) 1 (16.67) 0 0 9.7 0 0 1 (16.67) 5 (83.33) 0 11.4 0 0 1 (16.67) 4 (66.67) 1 (16.67) 27 0 1 (16.67) 4 (66.67) 1 (16.67) 0 38.7 1 (16.67) 1 (16.67) 3 (50.00) 1 (16.67) 0 142.4 0 0 1 (16.67) 3 (50.0) 2 (33.33) 366.7 0 0 0 3 (50.00) 3 (50.00) Abbreviation: VIBe Scale, Validated Intraoperative Bleeding Scale.
- Table 4
Pooled surgical specialists VIBe Scale responses and associated video bleeding rate.
Video Bleeding Rate, mL/min Participant Group VIBe Scale Response, N (%) 0 1 2 3 4 0.2 Spine surgeons 19 (76.00) 5 (20.00) 1 (4.00) 0 0 All surgeons 98 (77.17) 26 (20.47) 3 (2.36) 0 0 0.7 Spine surgeons 19 (76.00) 4 (16.00) 1 (4.00) 1 (4.00) 0 All surgeons 114 (89.76) 10 (7.87) 2 (1.57) 1 (0.79) 0 1.3 Spine surgeons 0 13 (52.00) 12 (48.00) 0 0 All surgeons 0 58 (45.67) 69 (54.33) 0 0 1.6 Spine surgeons 3 (12.00) 21 (84.00) 1 (4.00) 0 0 All surgeons 9 (7.09) 115 (90.55) 3 (2.36) 0 0 6.4 Spine surgeons 0 4 (16.00) 17 (68.00) 4 (16.00) 0 All surgeons 0 13 (10.24) 94 (74.02) 20 (15.75) 0 7.3 Spine surgeons 0 16 (64.00) 7 (28.00) 2 (8.00) 0 All surgeons 2 (1.57) 82 (64.75) 41 (32.28) 2 (1.57) 0 9.7 Spine surgeons 0 0 7 (28.00) 18 (72.00) 0 All surgeons 0 0 16 (12.60) 102 (80.31) 9 (7.09) 27 Spine surgeons 0 3 (12.00) 16 (64.00) 6 (24.00) 0 All surgeons 0 5 (3.94) 94 (74.02) 28 (22.05) 0 38.7 Spine surgeons 2 (8.00) 3 (12.00) 10 (40.00) 10 (40.00) 0 All surgeons 2 (1.57) 3 (2.36) 52 (40.94) 68 (53.54) 2 (1.57) 366.7 Spine surgeons 0 0 0 7 (28.00) 18 (72.00) All surgeons 0 0 0 12 (9.45) 115 (90.55) Abbreviation: VIBe Scale, Validated Intraoperative Bleeding Scale.
- Table 5
Interobserver and intraobserver agreement for the spine specialists and pooled surgical specialist samples.
Specialty Kendall’s W Agreement Status Interobserver agreement Orthopedic 0.79 Acceptable Neurological 0.88 Appreciable Combined spine 0.80 Appreciable Combined all 0.88 Appreciable Intraobserver agreement Orthopedic 0.91 Excellent Neurological 0.95 Excellent Combined spine 0.92 Excellent Combined all 0.96 Excellent
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