Intraoperative blood loss, postoperative drainage, and recovery in patients undergoing lumbar spinal surgery

Zou, Haibo; Li, Zhongshi; Sheng, Houfu; Tan, Mingsheng; Yang, Feng; Liang, Li; Zhao, Jia

doi:10.1186/s12893-015-0062-9

Cited by 23 publications

(9 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Indeed, preoperative anemia, together with the amount of perioperative HB drop, were shown to be independent risk factors for increased morbidity, mortality, and longer LOS, with overall increased healthcare costs [ 4 , 6 , 12 , 29 , 30 , 31 , 32 , 33 ]. Thus, the goal for an optimal pre-surgery patient’s preparation would be to detect a condition of anemia or borderline HB levels as early as possible before the scheduled surgery in order to provide correction with treatments directed to increase the RBC mass, i.e., administration of iron, vitamin B12, folic acid, and erythropoietin [ 34 , 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

Red Blood Cell Transfusion Need for Elective Primary Posterior Lumbar Fusion in A High-Volume Center for Spine Surgery

Ristagno

Beluffi

Tanzi

et al. 2018

JCM

View full text Add to dashboard Cite

(1) Background: This study evaluated the perioperative red blood cell (RBC) transfusion need and determined predictors for transfusion in patients undergoing elective primary lumbar posterior spine fusion in a high-volume center for spine surgery. (2) Methods: Data from all patients undergoing spine surgery between 1 January 2014 and 31 December 2016 were reviewed. Patients’ demographics and comorbidities, perioperative laboratory results, and operative time were analyzed in relation to RBC transfusion. Multivariate logistic regression analysis was performed to identify the predictors of transfusion. (3) Results: A total of 874 elective surgeries for primary spine fusion were performed over the three years. Only 54 cases (6%) required RBC transfusion. Compared to the non-transfused patients, transfused patients were mainly female (p = 0.0008), significantly older, with a higher ASA grade (p = 0.0002), and with lower pre-surgery hemoglobin (HB) level and hematocrit (p < 0.0001). In the multivariate logistic regression, a lower pre-surgery HB (OR (95% CI) 2.84 (2.11–3.82)), a higher ASA class (1.77 (1.03–3.05)) and a longer operative time (1.02 (1.01–1.02)) were independently associated with RBC transfusion. (4) Conclusions: In the instance of elective surgery for primary posterior lumbar fusion in a high-volume center for spine surgery, the need for RBC transfusion is low. Factors anticipating transfusion should be taken into consideration in the patient’s pre-surgery preparation.

show abstract

Section: Discussionmentioning

confidence: 99%

Red Blood Cell Transfusion Need for Elective Primary Posterior Lumbar Fusion in A High-Volume Center for Spine Surgery

Ristagno

Beluffi

Tanzi

et al. 2018

JCM

View full text Add to dashboard Cite

show abstract

“…Total blood loss of 1 to 2 L or more is common and patients are at risk of developing perioperative anemia, which has been shown to increase postoperative morbidity and mortality in a variety of clinical settings. 1-5 Because the mainstay of treatment for blood loss and perioperative anemia is transfusion, the incidence of transfusion in adult spine fusion surgery has been estimated to be as high as 50% to 81%. 6 Advancements in blood testing have markedly improved the safety of allogeneic blood products, but transfusions are not without risks.…”

Section: Introductionmentioning

confidence: 99%

Clinical Outcomes Associated With Allogeneic Red Blood Cell Transfusions in Spinal Surgery: A Systematic Review

Blackburn

Morrow

Tanenbaum

et al. 2018

Global Spine Journal

View full text Add to dashboard Cite

Study Design: Systematic review. Objectives: The objectives of this systematic review were to report the available clinical evidence on patient outcomes associated with perioperative allogeneic red blood cell (RBC) transfusions in adult patients undergoing spinal surgery and to determine whether there is any evidence to support an association between transfusion timing and clinical outcomes. Methods: A systematic review of the PubMed, EMBASE, and Cochrane Library databases was performed to identify all articles examining outcomes of adult spinal surgery patients who received perioperative allogeneic RBC transfusions. The level of evidence for each study was assessed using the “Oxford Levels of Evidence 2” classification system. Meta-analysis was not performed due to the heterogeneity of reports. Results: A total of 2759 unique citations were identified and 76 studies underwent full-text review. Thirty-four studies were selected for analysis. All the studies, except one, were retrospective. Eleven studies investigated intraoperative or postoperative transfusions. Only one article compared outcomes related to intraoperative versus postoperative transfusions. Conclusions: Perioperative transfusion is associated with increased rates of postoperative complications, especially infectious complications, and prolonged length of stay. Some evidence suggests that a dose-response relationship may exist between morbid events and the number of RBC units administered, but these findings are inconsistent. Because of the heterogeneity of reports and inconsistent findings, the incidence of specific complications remains unclear. Limited research activity has focused on intraoperative versus postoperative transfusions, or the effect of transfusion on functional outcomes of spine surgery patients. Further research is warranted to address these clinical issues.

show abstract

“…8 In addition, Zou et al showed that blood loss in lumbar spine surgery was associated with length of surgery. 12 Our results suggests that operative time was associated with transfusion requirements for both thoracic and lumbar fusion surgeries. Furthermore, thoracic fusion tends to involve more fusion segments, which has also been shown to be an independent factor for requiring blood transfusions.…”

Section: Discussionmentioning

confidence: 61%

Incidence, Predictors, and Postoperative Complications of Blood Transfusion in Thoracic and Lumbar Fusion Surgery: An Analysis of 13,695 Patients from the American College of Surgeons National Surgical Quality Improvement Program Database

Aoude

Nooh

Fortin

et al. 2016

Global Spine Journal

View full text Add to dashboard Cite

Study Design Retrospective cohort study. Objective To identify predictive factors for blood transfusion and associated complications in lumbar and thoracic fusion surgeries. Methods The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was used to identify patients who underwent lumbar or thoracic fusion from 2010 to 2013. Multivariate analysis was used to determine predictive factors and postoperative complications associated with transfusion. Results Out of 13,695 patients, 13,170 had lumbar fusion and 525 had thoracic fusion. The prevalence of transfusion was 31.8% for thoracic and 17.0% for lumbar fusion. The multivariate analysis showed that age between 50 and 60, age between 61 and 70, age > 70, dyspnea, American Society of Anesthesiologists class 3, bleeding disease, multilevel surgery, extended surgical time, return to operation room, and higher preoperative blood urea nitrogen (BUN) were predictors of blood transfusion for lumbar fusion. Multilevel surgery, preoperative BUN, and extended surgical time were predictors of transfusion for thoracic fusion. Patients receiving transfusions who underwent lumbar fusion were more likely to develop wound infection, venous thromboembolism, pulmonary embolism, and myocardial infarction and had longer hospital stay. Patients receiving transfusions who underwent thoracic fusion were more likely to have extended hospital stay. Conclusion This study characterizes incidence, predictors, and postoperative complications associated with blood transfusion in thoracic and lumbar fusion. Pre- and postoperative planning for patients deemed to be at high risk of requiring blood transfusion might reduce postoperative complications in this population.

show abstract

Intraoperative blood loss, postoperative drainage, and recovery in patients undergoing lumbar spinal surgery

Cited by 23 publications

References 21 publications

Red Blood Cell Transfusion Need for Elective Primary Posterior Lumbar Fusion in A High-Volume Center for Spine Surgery

Red Blood Cell Transfusion Need for Elective Primary Posterior Lumbar Fusion in A High-Volume Center for Spine Surgery

Clinical Outcomes Associated With Allogeneic Red Blood Cell Transfusions in Spinal Surgery: A Systematic Review

Incidence, Predictors, and Postoperative Complications of Blood Transfusion in Thoracic and Lumbar Fusion Surgery: An Analysis of 13,695 Patients from the American College of Surgeons National Surgical Quality Improvement Program Database

Contact Info

Product

Resources

About