210 / 245
210
· DOS Abstracts
Predictors of perioperative blood transfusion
in surgical treatment of adolescent idiopathic
scoliosis – one-center experience in 150 patients
Søren Ohrt-Nissen, Naeem Bukhari, Jacob Steensballe, Martin Gehrchen, Benny
Dahl
Orthopedic Surgery, Spine Unit, Rigshospitalet; Orthopedic Surgery, Spine Unit,
Rigshospitalet; Anaesthesiology, Rigshospitalet; Orthopedic Surgery, Spine Unit,
Rigshospitalet; Orthopedic Surgery, Spine Unit, Rigshospitalet
Background:
Surgical management of adolescent idiopathic scoliosis (AIS) in-
volves a risk of substantial perioperative bleeding despite the use of cell sal-
vage as well as infusion of antifibrinolytic agents. Avoidance of allogeneic blood
transfusion is of importance considering the cost, the infection risk and the risk
of autoimmunization.
Purpose / Aim of Study:
To investigate potential predictors of blood transfu-
sion following instrumented fusion for AIS in a center with well-defined transfu-
sion guidelines.
Materials and Methods:
A retrospective cohort study was carried out on all
patients undergoing posterior instrumented fusion for AIS in the period May 1st
2011 through December 31st 2015. Data was extracted from medical records
and surgical charts. A logistic regression analysis was conducted with transfu-
sion of red blood cells before discharge as outcome variable. Predictor variables
were chosen a priori.
Findings / Results:
The study included 149 patients. Mean age was 16.3±2.4
years and 83% were female. Fifty patients (34%) received transfusion and this
group had significantly higher preoperative Cobb angle, longer operation time,
lower body mass index (BMI) and a lower preoperative hemoglobin (hgb) than
the non- transfusion group (p < 0.014). Multiple logistic regression including
these factors as well as fusion length and mean arterial pressure showed that
only BMI (OR: 0,77, 95% CI: 064-089) and preoperative hgb (OR: 0,26; 95%
CI: 0,12-0,50) were significantly associated with risk of transfusion. Nine out
of ten patients with a preoperative hgb level of less than 7.5 mmol/l required
transfusion.
Conclusions:
Preoperative hgb was the strongest predictor of patients requir-
ing transfusion following surgery for AIS. Adopting a preoperative minimum
level of 7.5 mmol/l may be considered.
No conflicts of interest reported
161.