Influence of curve magnitude and other variables on operative time, blood loss and transfusion requirements in adolescent idiopathic scoliosis

Abstract

Larger preoperative curve magnitudes in AIS increase operative time and intraoperative blood loss; preoperative Cobb angles greater than 70(o) and intraoperative blood loss greater than 1400 ml are predictive of red blood cell transfusion requirement in this patient group.

Blood transfusion in the surgical treatment of adolescent idiopathic scoliosis—a single‐center experience of patient blood management in 210 cases

“…). Additional predictors of RBC transfusion were a low preoperative Hb concentration, a severe curve magnitude, and an increase in EBL, in accordance with previously published results …”

“…These cutoffs were based on density plots (Fig. ), the 25% quartile value, and the current literature . Sixteen patients (8%) had a preoperative Hb level of no more than 12 g/dL and had 9.26 times higher odds of receiving RBCs compared with the non‐RBC group.…”

“…The major curve was defined as the Cobb angle of the main curve and was measured at the preoperative and 1‐week postoperative time points. Curves were grouped as severe or moderate based on a 70‐degree threshold . Preoperative flexibility was calculated based on a preoperative lateral‐bending radiograph.…”

“…Another pillar of PBM is the preoperative identification of patients who are at risk of receiving perioperative blood transfusion. Several predictors have been suggested in relation to the risk of blood loss or transfusion in AIS, including age, sex, curve magnitude, duration of surgery, low preoperative hemoglobin (Hb), fusion length, and surgical expertise . However, results are contradictory, and the clinical applicability is not well established, because studies vary in methodology and primary endpoints.…”

Predicting massive transfusion in adolescent idiopathic scoliosis patients undergoing corrective surgery

“…[26] Nugent et al, Tarrant et al, and Yu et al clarified that a larger Cobb angle was associated with excessive intraoperative bleeding. [12,27,28] In this study, we observed that blood loss tended to be greater when Cobb angle was larger. This can be explained by the relationship between Cobb angle and surgical complexity.…”