PT  - JOURNAL ARTICLE
AU  - Daniel M. Sciubba
AU  - Nitin Khanna
AU  - Zach Pennington
AU  - Rahul K. Singh
TI  - VIBe Scale: Validation of the Intraoperative Bleeding Severity Scale by Spine Surgeons
AID  - 10.14444/8304
DP  - 2022 Aug 01
TA  - International Journal of Spine Surgery
PG  - 740--747
VI  - 16
IP  - 4
4099  - http://ijssurgery.com//content/16/4/740.short
4100  - http://ijssurgery.com//content/16/4/740.full
SO  - Int J Spine Surg2022 Aug 01; 16
AB  - Background The Validated Intraoperative Bleeding Scale (VIBe Scale) was initially validated with surgeons who operate on cardiothoracic, abdominal, and pelvic cavities and fulfilled criteria for a clinician-reported scale. However, there is a need for a tool to aid in intraoperative blood management during spine surgeries. The purpose of the present study was to establish the reliability and consistency of the VIBe Scale as a tool for spine surgeons to assess intraoperative bleeding.Methods Orthopedic (n = 16) and neurological (n = 9) spine surgeons scored videos depicting surgical bleeding and assessed the VIBe Scale’s relevance and clarity. Inter- and intraobserver agreement (Kendall’s W) were calculated for all surgeons and pooled with responses from the original study to establish agreement across specialties.Results All of the spine surgeons indicated that the scale was clinically relevant for evaluating hemostasis and could be implemented in a clinical study. Twenty-two spine surgeons (88%) reported that the scale represents the range of bleeding site sizes and severities expected in their practice. Twenty-four spine surgeons (96%) indicated that the scale would be useful in communicating bleeding severity with other members of the surgical team. Interobserver agreement was acceptable (0.79) for orthopedic specialists, appreciable (0.88) for neurological specialists, and appreciable (0.88) for the combined specialists. Intraobserver agreement was excellent for orthopedic (0.91) and neurological (0.91) spine surgeons and excellent (0.96) for the combined specialists.Conclusions The results highlight the reliability of the VIBe Scale and potential utility for quantifying intraoperative blood loss in spine surgery.Level of Evidence 3.Clinical Relevance The VIBe Scale may be useful for evaluating the efficacy of untested intraoperative hemostatic agents and for comparing the relative efficacy of 2 or more analogous agents. It may also prove useful for intraoperative staff by quantifying ongoing intraoperative blood loss and correlating losses with the potential transfusion and intraoperative hemostatic agent requirements.