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J. Clin. Med. 2018, 7(2), 19; https://doi.org/10.3390/jcm7020019

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

1
Neurosurgery I, Neuro Center, Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy
2
Management Control Unit, Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy
*
Author to whom correspondence should be addressed.
Received: 31 December 2017 / Revised: 9 January 2018 / Accepted: 23 January 2018 / Published: 30 January 2018
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Abstract

(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. View Full-Text
Keywords: blood; blood loss; spine surgery; spine fusion; lumbar; transfusion; red blood cell; hemoglobin; predictors; operative time blood; blood loss; spine surgery; spine fusion; lumbar; transfusion; red blood cell; hemoglobin; predictors; operative time
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Ristagno, G.; Beluffi, S.; Tanzi, D.; Belloli, F.; Carmagnini, P.; Croci, M.; D’Aviri, G.; Menasce, G.; Pastore, J.C.; Pellanda, A.; Pollini, A.; Savoia, G. Red Blood Cell Transfusion Need for Elective Primary Posterior Lumbar Fusion in A High-Volume Center for Spine Surgery. J. Clin. Med. 2018, 7, 19.

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