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The Effect Of Blood Transfusion On Short-term, Perioperative Outcomes In Elective Spine Surgery | 19934
ISSN: 2155-9864

Journal of Blood Disorders & Transfusion
Open Access

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2nd International Conference on Hematology & Blood Disorders

Nima Alan, Andreea Seicean, Sinziana Seicean, Duncan Neuhauser and Robert J Weil
Accepted Abstracts: J Blood Disorders Transf
DOI: 10.4172/2155-9864.S1.008
Abstract
Background: Studies in various surgical specialties have shown that transfusion of red blood cells (RBC) increases the risk of postoperative morbidity and mortality. Impact of blood transfusion in patients undergoing spine surgery is not well-described. We assessed the impact of intra- and postoperative transfusion on postoperative morbidity and mortality in patients undergoing elective spine surgery. Methods: We used National Surgical Quality Improvement Program (NSQIP) to identify a retrospective cohort of 36,901 adult patients who underwent elective spine surgery, between 2006 and 2011. Patients who received intra- or post-operative transfusion (n=3,262) were matched to those who did not, using propensity scores. Logistic regression predicted adverse postoperative outcomes. We conducted sensitivity analysis in a subset of patients in whom number of intraoperatively transfused units of RBC or whole blood was known. Results: Upon matching, preoperative hematocrit, length of surgery, and percentage of spinal fusion surgery were not significantly different between transfused and non-transfused patients. After matching, transfusion remained adversely associated with prolonged length of stay (LOS) in hospital (OR 2.6, 95% CI 2.3-2.9), postoperative complications (OR 1.6, 95% CI 1.4-1.9), and an increased 30-day return to operation room (OR 1.7, 95% CI 1.3-2.2). Transfusion of even one unit of blood intraoperatively was associated with prolonged LOS (OR 2.0, 95% CI 1.5-2.6) and minor complications (OR 2.4, 95% CI 1.3-4.3). Conclusion: Transfusion of RBC or whole blood, even of a single unit, increased LOS and postoperative morbidity in patients undergoing elective spine surgery, independent of preoperative hematocrit level and patient comorbidities.
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