Transfusion guidelines in adult spine surgery: a systematic review and critical summary of currently available evidence

Barrie, Umaru; Youssef, Carl; Pernik, Mark N.; Adeyemo, Emmanuel; Elguindy, Mahmoud M.; Johnson, Zachary D; Ahmadieh, Tarek Y. El; Akbik, Omar S.; Bagley, Carlos A.; Aoun, Salah G.

doi:10.1016/j.spinee.2021.07.018

Cited by 21 publications

(18 citation statements)

References 38 publications

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“…A research had thinks that whether patients undergoing lumbar spine surgery receive allogeneic blood transfusion during or after surgery, the risk of infection at the surgical site, urinary tract infection and overall postoperative infection will increase, except that the risk of pneumonia is not increased [31]. Therefore, based on the current research, whether blood transfusion is required during the perioperative period of lumbar spine surgery, we should follow the blood transfusion principles or guidelines [32].…”

Section: Discussionmentioning

confidence: 99%

Predicting the Surgical Site Infections in Patients Undergoing Lumbar Internal Fixation Surgery: A New Predictive Nomogram is Evelopmenting and Assessmenting

Chen

Liu

Zhang

et al. 2022

Preprint

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Purpose The purpose of this research is to develop and validate a nomogram of the risk of surgical site infections in Patients Undergoing lumbar Internal Fixation Surgery. Patients and methods: We had collected a total of 1327 patients with lumbar internal fixation surgery, 1273 patients were normal lumbar fixation group and 54 patients in the surgical site infections group. Patients are divided into two echelons of testing and verification, and R software is used as the only statistical analysis. In the training tests, first, single factor logistic regression analysis was used to select potential predictors with significant p-values. Then multivariate logistic regression analysis is used to filter out the predictors which we need. A nomogram was constructed using the coefficients of variable provided by Multivariate logistic regression analysis, the calibration and clinical applicability of the predictive model are evaluated by using the C index, calibration curve, and decision curve. In addition, we use internal verification tests to verify the built model. Results This unprecedented nomogram of SSI risk for lumbar Internal Fixation Surgery includes modic status, glucose, Hb, ESR, blood transfusion, sebum thickness. The model shows a good degree of discrimination, with a C index of 0.975 (95% confidence interval: 0. 964, 0. 987) and good alignment. The decision curve analysis showed that the SSI nomogram is clinically meaningful when the 1% probability threshold of the normal group is used to determine the intervention. The C-index of the validation test was 0.981(95% confidence interval: 0. 957, 1.005). Conclusion This novel SSI prediction nomogram combines Modic status, glucose, Hb, ESR, blood transfusion, sebum thickness, and can be easily used for individualized SSI probability prediction in lumbar Internal Fixation Surgery patients.

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Section: Discussionmentioning

confidence: 99%

Predicting the Surgical Site Infections in Patients Undergoing Lumbar Internal Fixation Surgery: A New Predictive Nomogram is Evelopmenting and Assessmenting

Chen

Liu

Zhang

et al. 2022

Preprint

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“…8 Hemodynamic instability that fulfills the criteria for Class III hemorrhage was also an indication for transfusion. 9 Body weight of the patient was calculated by using formula as: weight (kg) = 0.5759 x (arm circumference, cm) + 0.5263 x (abdominal circumference, cm) + 1.2452 x (calf circumference, cm) -4.8689 x (Sex, male = 1 and female = 2) -32.9241. 10 Proforma was filled separately for every patient.…”

Section: Methodsmentioning

confidence: 99%

Efficacy of Intravenous Tranexamic Acid on Perioperative Blood Loss and Transfusion Requirement in Spine Fusion Surgery

2023

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Introduction: Blood loss associated with spine fusion surgery is a common potential cause of morbidity and often requires a blood transfusion, which subjects patients to risks of blood transfusion. Tranexamic acid is used intra-operatively to reduce bleeding in major surgeries. This study aims to evaluate its efficacy on perioperative blood loss and transfusion requirement in patients undergoing spine fusion surgery Methods: This prospective randomised controlled study was conducted at Department of Orthopedics of Tribhuvan University Teaching Hospital between August 2015 and July 2016. Patients undergoing spine fusion surgery were randomly assigned to group A (TXA) and group B (control) equally, thirty patients in each group. TXA was given to group A in a loading dose of 10 mg/kg, followed by continuous infusion of 1 mg/kg/hr during surgery. Outcome measures included perioperative blood loss, amount of blood transfusion, and safety and adverse effects. The data were analyzed by means of SPSS version 21.0. The results were presented as mean ± SD. Differences were considered significant if the P-value was <0.05. Results: Sixty patients (31 males, 29 females) with mean age of 39.95 years were enrolled in study, thirty patients in each group. Statistical analysis showed no significant differences between the 2 study groups with regard to age, sex, weight, preoperative hemoglobin, level of fusion as well as operative time. The amount of perioperative blood loss was significantly less in the group A versus group B, 241.274±162.819 ml vs 661.053±189.469 ml, p=0.000. There was no difference in the incidence of allogenic blood transfusion. There were no complications related to use of TXA in this study. Conclusion: TXA provided an effective and safe method for reduction of blood loss during and after spine fusion surgery. However, there was no difference in the incidence of perioperative allogeneic blood transfusion.

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“…independently performed the data extraction according to the aforementioned search strategy. 9 Articles were initially screened by title and abstract. Full-text review was performed on relevant articles for extraction of pertinent data.…”

Section: Methodsmentioning

confidence: 99%

Transfusion Guidelines in Traumatic Brain Injury: A Systematic Review and Meta-Analysis of the Currently Available Evidence

Montgomery

Barrie

Kenfack

et al. 2022

Neurotrauma Reports

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Our study aims to provide a synthesis of the best available evidence on the hemoglobin (hgb) red blood cell (RBC) transfusion thresholds in adult traumatic brain injury (TBI) patients, as well as describing the risk factors and outcomes associated with RBC transfusion in this population. A systematic review and meta-analysis was conducted using PubMed, Google Scholar, and Web of Science electronic databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to assess articles discussing RBC transfusion thresholds and describe complications secondary to transfusion in adult TBI patients in the perioperative period. Fifteen articles met search criteria and were reviewed for analysis. Compared to non-transfused, TBI patients who received transfusion tended to be primarily male patients with worse Injury Severity Score (ISS) and Glasgow Coma Scale. Further, the meta-analysis corroborated that transfused TBI patients are older ( p = 0.04), have worse ISS scores ( p = 0.001), receive more units of RBCs ( p = 0.02), and have both higher mortality ( p < 0.001) and complication rates ( p < 0.0001). There were no differences identified in rates of hypertension, diabetes mellitus, and Abbreviated Injury Scale scores. Additionally, whereas many studies support restrictive (hgb <7 g/dL) transfusion thresholds over liberal (hgb <10 g/dL), our meta-analysis revealed no significant difference in mortality between those thresholds ( p = 0.79). Current Class B/C level III evidence predominantly recommends against a liberal transfusion threshold of 10 g/dL for TBI patients (Class B/C level III), but our meta-analysis found no difference in survival between groups. There is evidence suggesting that an intermediate threshold between 7 and 9 g/dL, reflecting the physiological oxygen needs of cerebral tissue, may be worth exploring.

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Transfusion guidelines in adult spine surgery: a systematic review and critical summary of currently available evidence

Cited by 21 publications

References 38 publications

Predicting the Surgical Site Infections in Patients Undergoing Lumbar Internal Fixation Surgery: A New Predictive Nomogram is Evelopmenting and Assessmenting

Predicting the Surgical Site Infections in Patients Undergoing Lumbar Internal Fixation Surgery: A New Predictive Nomogram is Evelopmenting and Assessmenting

Efficacy of Intravenous Tranexamic Acid on Perioperative Blood Loss and Transfusion Requirement in Spine Fusion Surgery

Transfusion Guidelines in Traumatic Brain Injury: A Systematic Review and Meta-Analysis of the Currently Available Evidence

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