Assessing the Rates, Predictors, and Complications of Blood Transfusion Volume in Posterior Arthrodesis for Adolescent Idiopathic Scoliosis

Retrospective cohort study. To determine predictors of and 30-day complications associated with blood transfusion volume after posterior spinal fusion for adolescent idiopathic scoliosis (AIS). Posterior arthrodesis is a common procedure performed for AIS, and patients frequently require perioperati...

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Vydáno v:Spine (Philadelphia, Pa. 1976) Ročník 40; číslo 18; s. 1422
Hlavní autoři: Minhas, Shobhit V, Chow, Ian, Bosco, Joseph, Otsuka, Norman Y
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 15.09.2015
Témata:
Adolescent
Age Factors
Blood Loss, Surgical - mortality
Blood Loss, Surgical - prevention & control
Blood Transfusion - mortality
Chi-Square Distribution
Child
Databases, Factual
Female
Humans
Male
Multivariate Analysis
Odds Ratio
Retrospective Studies
Risk Factors
Scoliosis - diagnosis
Scoliosis - mortality
Scoliosis - physiopathology
Scoliosis - surgery
Spinal Fusion - adverse effects
Spinal Fusion - mortality
Time Factors
Transfusion Reaction
Treatment Outcome
United States
ISSN:1528-1159, 1528-1159
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Shrnutí:Retrospective cohort study. To determine predictors of and 30-day complications associated with blood transfusion volume after posterior spinal fusion for adolescent idiopathic scoliosis (AIS). Posterior arthrodesis is a common procedure performed for AIS, and patients frequently require perioperative blood transfusions. Few studies, however, have examined the rates and potential complications associated with blood transfusion volume. Patients undergoing posterior arthrodesis for AIS were selected from the National Surgical Quality Improvement Program pediatric database from 2012 to 2013. Patients were stratified on the basis of blood transfusion volume and patient demographics and comorbidities, operative characteristics, and 30-day complications were recorded. Multivariate analyses were performed to determine predictors of transfusion as well as the effect of transfusion volume on 30-day complication rates. A total of 1691 patients were included. Male sex (P = 0.010), esophageal or gastrointestinal disease (P = 0.016), cardiac risk factors (P = 0.037), preoperative inotrope requirement (P = 0.031), total operative time of 300 minutes or more (P < 0.001), and posterior arthrodesis of 13 or more vertebral segments (P < 0.001) were independent risk factors for requiring blood transfusion. Total transfusion volume of 20 mL/kg or more was the minimum volume independently associated with increased rates of total complications (P = 0.018), with a complication rate of 5.9%. We present the first large, comprehensive analysis of complications related to blood transfusion events and transfusion volume on short-term postoperative complications after posterior arthrodesis for AIS. Although transfusion in general is not associated with 30-day adverse events, a volume of 20 mL/kg was associated with higher complication rates. 4.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:1528-1159
1528-1159
DOI:10.1097/BRS.0000000000001019