BACKGROUND: Surgery for posterior spine instrumentation often requires major transfusion. The aim of this study was to develop and test the validity of a model for predicting intraoperative major transfusion (>4 U total red blood cells), based on preoperative patient and surgical variables, that was applicable to adult patients undergoing cervical, thoracic, and/or lumbar spine deformity surgery with and without osteotomies. MATERIALS AND METHODS: The perioperative data from 548 patients who underwent ≥ 3 levels of posterior spinal fusion with instrumentation between January 1, 2003 and May 30, 2009, were retrospectively collected to create a model for predicting major blood transfusion. The validity of the model was retrospectively tested with a separate data set of 95 patients who underwent surgery from June 1, 2009 through September 30, 2010. RESULTS: There was a 59.5% incidence of major transfusion in the derivation set of patients. Independent predictors of major transfusion were operation duration, number of posterior levels instrumented, surgical complexity score, and preincision hemoglobin. This model was able to predict major transfusion significantly better than a previously published model (ROCAUC=0.89; 99% confidence interval, 0.80-0.90; P<0.001). CONCLUSIONS: Our model has an increased accuracy for predicting the probability of major transfusion compared with a previously published model. In addition, our model is applicable to all types of spine fusion surgery and accounts for the complexity of surgical instrumentation, the number of levels instrumented, and the predicted duration of surgery as independent variables.
BACKGROUND: Surgery for posterior spine instrumentation often requires major transfusion. The aim of this study was to develop and test the validity of a model for predicting intraoperative major transfusion (>4 U total red blood cells), based on preoperative patient and surgical variables, that was applicable to adult patients undergoing cervical, thoracic, and/or lumbar spine deformity surgery with and without osteotomies. MATERIALS AND METHODS: The perioperative data from 548 patients who underwent ≥ 3 levels of posterior spinal fusion with instrumentation between January 1, 2003 and May 30, 2009, were retrospectively collected to create a model for predicting major blood transfusion. The validity of the model was retrospectively tested with a separate data set of 95 patients who underwent surgery from June 1, 2009 through September 30, 2010. RESULTS: There was a 59.5% incidence of major transfusion in the derivation set of patients. Independent predictors of major transfusion were operation duration, number of posterior levels instrumented, surgical complexity score, and preincision hemoglobin. This model was able to predict major transfusion significantly better than a previously published model (ROCAUC=0.89; 99% confidence interval, 0.80-0.90; P<0.001). CONCLUSIONS: Our model has an increased accuracy for predicting the probability of major transfusion compared with a previously published model. In addition, our model is applicable to all types of spine fusion surgery and accounts for the complexity of surgical instrumentation, the number of levels instrumented, and the predicted duration of surgery as independent variables.
Authors: Pavel S Roshanov; John W Eikelboom; Mark Crowther; Vikas Tandon; Flavia K Borges; Clive Kearon; Andre Lamy; Richard Whitlock; Bruce M Biccard; Wojciech Szczeklik; Gordon H Guyatt; Mohamed Panju; Jessica Spence; Amit X Garg; Michael McGillion; Tomas VanHelder; Peter A Kavsak; Justin de Beer; Mitchell Winemaker; Daniel I Sessler; Yannick Le Manach; Tej Sheth; Jehonathan H Pinthus; Lehana Thabane; Marko R I Simunovic; Ryszard Mizera; Sebastian Ribas; P J Devereaux Journal: CMAJ Open Date: 2017-08-04
Authors: Michael P Kelly; Lukas P Zebala; Han Jo Kim; Daniel M Sciubba; Justin S Smith; Christopher I Shaffrey; Shay Bess; Eric Klineberg; Gregory Mundis; Douglas Burton; Robert Hart; Alex Soroceanu; Frank Schwab; Virginie Lafage Journal: J Neurosurg Spine Date: 2015-09-25
Authors: Peter G Passias; Gregory W Poorman; Edward Delsole; Peter L Zhou; Samantha R Horn; Cyrus M Jalai; Shaleen Vira; Bassel Diebo; Virginie Lafage Journal: Global Spine J Date: 2017-10-24
Authors: Ahmed Aoude; Sultan Aldebeyan; Maryse Fortin; Anas Nooh; Peter Jarzem; Jean A Ouellet; Michael H Weber Journal: Asian Spine J Date: 2017-12-07
Authors: Giuseppe Ristagno; Simonetta Beluffi; Dario Tanzi; Federica Belloli; Paola Carmagnini; Massimo Croci; Giuseppe D'Aviri; Guido Menasce; Juan C Pastore; Armando Pellanda; Alberto Pollini; Giorgio Savoia Journal: J Clin Med Date: 2018-01-30 Impact factor: 4.241