Wasting of preoperatively donated autologous blood in the surgical treatment of adolescent idiopathic scoliosis.
METHODS
Retrospective, case-control.


OBJECTIVE
Evaluate the utility of preoperative autologous blood donation (PABD) for surgical treatment of adolescent idiopathic scoliosis (AIS).


BACKGROUND
Recent data have highlighted overuse of PABD in elective surgery; however, PABD is a major blood conservation strategy for AIS surgery.


METHODS
Medical records of 123 patients treated for AIS between June 1995 and November 2004 were reviewed. Patients were divided into PABD (n = 104) and nondonors (NPABD; n = 19).


RESULTS
No differences existed between PABD and NPABD for age, major curve size, or operative procedures. Average PABD preoperative hematocrit was lower than NPABD (37.8 vs. 40.2; P < 0.005). PABD patients were 9 times more likely to be transfused than NPABD, and 3 times more likely to be transfused for each unit donated. There was a 25% transfusion risk reduction for each percent preoperative hematocrit increase. Minimum one autologous unit was not transfused in 32 patients (31%). Twenty-nine PABD patients (28%) were transfused for hematocrit >30. Fifty-three PABD patients (51%) wasted at least one unit or were transfused for hematocrit >30.


CONCLUSIONS
The majority of PABD patients (51%) wasted minimum one autologous unit or were transfused at a high hematocrit (>30). More precise PABD guidelines are needed to limit unnecessary transfusion and wasted resources.
Bess
R Shay
RS
Washington University Medical Center, Department of Orthopaedic Surgery, St. Louis, MO, USA. shay.bess@hsc.utah.edu
Lenke
Lawrence G
LG
Bridwell
Keith H
KH
Steger-May
Karen
K
Hensley
Marsha
M
D000293:Adolescent; D001782:Blood Donors / Q000706:statistics & numerical data*; D001804:Blood Transfusion, Autologous / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D005260:Female; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006400:Hematocrit; D006801:Humans; D008297:Male; D011300:Preoperative Care / Q000379:methods* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012600:Scoliosis / Q000601:surgery*