Predictors of blood transfusion in patients undergoing elective surgery for degenerative conditions of the spine.
BACKGROUND
The requirement of blood in the surgery of degenerative conditions of lumbar spine is around 10 %. Preoperative autologous blood donation is an effective method that is used in surgeries with an important blood loss. This is an expensive method because of the great number of predonated blood units not used in the postoperative period (around 70 % in our practice).


OBJECTIVE
To know the risk factors associated with transfusion in the postoperative period in patients who undergo surgeries of degenerative conditions of the lumbar spine.


METHODS
We designed a retrospective study of 142 cases of patients operated for degenerative conditions of the lumbar spine (not including simple disk hernia or adult degenerative scoliosis).


RESULTS
Female sex, age >60 years, preoperative ASA score 3 and preoperative hemoglobin ≤136 g/L are the risk factors related to the need of blood transfusion in the postoperative period. After application of a statistical study, female sex and preoperative ASA score 3 were the most important variables to explain transfusional risk. A woman with ASA score 3 has a 61 % foretold probability to be transfused in the postoperative period, while a man with ASA < 3, only 1.1 %. For this reason, application of this method to patients with these risk factors is more cost-effective.


CONCLUSIONS
Females, ASA 3, preoperative hemoglobin ≤136 g/L and age older than 60 years increase the risk to be transfused in the postoperative period for degenerative conditions of the spine.
Orthopaedic Departement Parc de Salut Mar, Universitat Autònoma Barcelona, Passeig Marítim 25-29, 08003 Barcelona, Spain. RTorresClaramunt@parcdesalutmar.cat
Raúl
R
Torres-Claramunt
Manuel
M
Ramírez
Mercedes
M
López-Soques
Guillem
G
Saló
Antoni
A
Molina-Ros
Andreu
A
Lladó
Enric
E
Cáceres
D000328:Adult; D000368:Aged; D001803:Blood Transfusion; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013122:Spinal Diseases / Q000601:surgery*; D013131:Spine / Q000601:surgery*