caa a22 4500 445834390 CHVBK 20180317145326.0 cr unu---uuuuu 170323e20110501xx s 000 0 eng 10.1007/s00586-010-1500-0 doi (NATIONALLICENCE)springer-10.1007/s00586-010-1500-0 Risk analysis of blood transfusion requirements in emergency and elective spinal surgery [Elektronische Daten] [Joseph Butler, John Burke, Roisin Dolan, Philip Fitzpatrick, John O'Byrne, Damian McCormack, Keith Synnott, Ashley Poynton] Spinal surgery has long been considered to have an elevated risk of perioperative blood loss with significant associated blood transfusion requirements. However, a great variability exists in the blood loss and transfusion requirements of differing patients and differing procedures in the area of spinal surgery. We performed a retrospective study of all patients undergoing spinal surgery who required a transfusion ≥1U of red blood cells (RBC) at the National Spinal Injuries Unit (NSIU) at the Mater Misericordiae University Hospital over a 10-year period. The purpose of this study was to identify risk factors associated with significant perioperative transfusion allowing the early recognition of patients at greatest risk, and to improve existing transfusion practices allowing safer, more appropriate blood product allocation. 1,596 surgical procedures were performed at the NSIU over a 10-year period. 25.9% (414/1,596) of these cases required a blood transfusion (n=414). Surgical groups with a significant risk of requiring a transfusion >2U RBC included deformity surgery (RR=3.351, 95% CI 1.123-10.006, p=0.03), tumor surgery (RR=3.298, 95% CI 1.078-10.089, p=0.036), and trauma surgery (RR=2.444, 95% CI 1.183-5.050, p=0.036). Multivariable logistic regression analysis identified multilevel surgery (>3 levels) as a significant risk of requiring a transfusion >2U RBC (RR=4.682, 95% CI 2.654-8.261, p<0.0001). Several risk factors in the spinal surgery patient were identified as corresponding to significant transfusion requirements. A greater awareness of the risk factors associated with transfusion is required in order to optimize patient management. Springer-Verlag, 2010 Blood loss nationallicence Transfusion requirement nationallicence Spinal surgery nationallicence Butler Joseph National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland aut Burke John National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland aut Dolan Roisin National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland aut Fitzpatrick Philip National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland aut O'Byrne John National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland aut McCormack Damian National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland aut Synnott Keith National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland aut Poynton Ashley National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland aut European Spine Journal Springer-Verlag 20/5(2011-05-01), 753-758 0940-6719 20:5<753 2011 20 586 https://doi.org/10.1007/s00586-010-1500-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-010-1500-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Butler Joseph National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland aut NATIONALLICENCE 700 1- Burke John National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland aut NATIONALLICENCE 700 1- Dolan Roisin National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland aut NATIONALLICENCE 700 1- Fitzpatrick Philip National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland aut NATIONALLICENCE 700 1- O'Byrne John National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland aut NATIONALLICENCE 700 1- McCormack Damian National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland aut NATIONALLICENCE 700 1- Synnott Keith National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland aut NATIONALLICENCE 700 1- Poynton Ashley National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20/5(2011-05-01), 753-758 0940-6719 20:5<753 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer