ObjectiveTo investigate the relationship between surgical risk factors and intraoperative blood loss in carotid body tumor resection.MethodsA retrospective analysis conducted. Clinical data of 227 patients who underwent carotid body tumor resection in the Department of Vascular Surgery at the First Affiliated Hospital of Naval Military Medical University and the Department of Gerneral Surgury at the Shanghai Seventh People's Hospital between November 2008 and October 2020 were retrospectively collected by the hospital's electronic medical record system. There were 130 males and 97 females, with a mean age of (43.55±13.30) years. Demographic data (age, sex, body mass index[BMI], systolic and diastolic blood pressures at admission, alcohol consumption, and smoking history), comorbidities (hypertension, diabetes, coronary artery disease, and cerebrovascular disease), and surgical variables (operation duration, intraoperative blood loss, covered stent implantation, artificial vascular replacement, and preoperative embolization) were compared among the three Shamblin classification groups. Univariate and multivariate regression analyses were performed to identify surgical risk factors influencing intraoperative blood loss.ResultsSignificant differences were observed among the three Shamblin types in BMI, operation duration, intraoperative blood loss, vascular reconstruction methods, and preoperative embolization (all P<0.05). Univariate logistic regression analysis revealed that intraoperative blood loss was negatively correlated with age (β=－14.31, 95%CI: －20.65 to －7.97), BMI (β=－29.47, 95%CI: －55.33 to －3.60) (P<0.01 or 0.05), while positively correlated with vascular reconstruction (β=688.09, 95%CI: 452.23 to 923.95) and Shamblin type Ⅲ carotid body tumors (β=627.38, 95%CI: 385.28 to 869.49) (both P<0.01). No significant association was found between intraoperative blood loss and preoperative laboratory parameters, including white blood cell count, lymphocyte percentage, neutrophil percentage, red blood cell count, hemoglobin, platelet count, D-dimer, thrombin time, prothrombin time (PT), activated partial thromboplastin time (APTT), fibrin degradation products, or fibrinogen (all P>0.05). Factors demonstrating statistical significance (age, BMI, Shamblin classification of carotid body tumor, and surgical approach), along with preoperative carotid artery embolization, were incorporated into multivariate logistic regression analysis. As shown in Model 3, age (β=－10.30, 95%CI: －17.41 to －3.20, P<0.01) was a protective factor for intraoperative blood loss, Shamblin type Ⅲ carotid body tumors (β=573.93, 95%CI: 321.53 to 826.34) and vascular reconstruction (β=361.64, 95%CI: 107.53 to 615.76) were identified as significant risk factors for intraoperative blood loss (all P<0.01), whereas preoperative embolization showed no significant effect (β=－297.23, 95%CI: －651.11 to 56.66, P>0.05).ConclusionAge is a protective factor for intraoperative blood loss in carotid body tumor resection. Shamblin type Ⅲ carotid body tumor, and vascular reconstruction are risk factors for intraoperative blood loss in carotid body tumor resection.