title: The effect of omega-3 fatty-acid supplements on perioperative bleeding following posterior spinal arthrodesis.
abstract: OBJECTIVE
  To investigate the effect of omega-3 fatty-acid supplements (n-3FA) on bleeding during posterior spinal arthrodesis.
  
  
  METHODS
  We reviewed all one- or two-level posterolateral lumbar decompression/fusions with or without interbody fusion by five surgeons within 3 years. Patients taking n-3FA preoperatively were matched 1:2 with controls based on procedure, surgeon and operative time. Patients with abnormal coagulation parameters, known bleeding disorders or other medications that could affect surgical blood loss were excluded.
  
  
  RESULTS
  Twenty-eight patients met inclusion criteria. The n-3FA and control groups were similar with respect to gender, age, body mass index, operative time, and preoperative use of non-steroidal anti-inflammatory drugs. The n-3FAs were stopped an average of 5.2 days before surgery (range 1-10). Mean estimated blood loss (EBL) was 697 ml in the n-3FA group and 771 ml in the control group (p = 0.36). Mean transfused volume of Cell Saver (CS) was 282 ml in the n-3FA group and 321 ml in the control group (p = 0.30). A post hoc power analysis showed that the study was powered to detect a minimum difference of 105 ml for EBL and 50 ml for CS. The multivariate generalized estimating equation did not show a significant difference between groups for EBL or CS (p = 0.35 and p = 0.29, respectively). Secondary outcomes including drop in postoperative hemoglobin, transfusion requirement, complications and surgical drain output were similar between the two groups.
  
  
  CONCLUSIONS
  The n-3FA use did not contribute to higher perioperative blood loss during spinal arthrodesis.
authors.affiliation: Department of Orthopedic Surgery, Hospital for Special Surgery, 535 E 70th ST, New York, NY 10021, USA. meredithd@hss.edu
authors.forename: Dennis S
authors.initials: DS
authors.lastname: Meredith
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Kepler
authors.forename: Russel C
authors.initials: RC
authors.lastname: Huang
authors.forename: Brandon
authors.initials: B
authors.lastname: Hirsch
authors.forename: Joseph
authors.initials: J
authors.lastname: Nguyen
authors.forename: James C
authors.initials: JC
authors.lastname: Farmer
authors.forename: Federico P
authors.initials: FP
authors.lastname: Girardi
authors.forename: Patrick F
authors.initials: PF
authors.lastname: O'Leary
authors.forename: Frank P
authors.initials: FP
authors.lastname: Cammisa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019587:Dietary Supplements / Q000009:adverse effects*; D015525:Fatty Acids, Omega-3 / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage; D012189:Retrospective Studies; D013123:Spinal Fusion
chemical_list: D015525:Fatty Acids, Omega-3