title: Perioperative blood transfusion does not decrease survival after surgical treatment of spinal metastases.
abstract: OBJECTIVE
  To assess whether perioperative allogenic blood transfusions in patients undergoing surgical treatment for spinal metastases independently influence patient survival.
  
  
  METHODS
  A retrospective study including 170 consecutive patients undergoing surgical treatment for spinal metastases in 2009 and 2010 at a tertiary referral center. Variables related to postoperative survival were all included in the same multivariable logistic regression analysis with either 3- or 12-month survival as the dependent variable. The independent variables were: transfusion of allogenic red blood cells, age at surgery, gender, preoperative hemoglobin, revised Tokuhashi score and no. of instrumented levels.
  
  
  RESULTS
  Perioperative allogenic blood transfusion of 1-2 units was associated with increased 12-month survival [p = 0.049, odds ratio 2.619 (confidence interval 1.004-6.831)], but not with 3-month survival. Larger transfusion volumes did not significantly influence survival.
  
  
  CONCLUSIONS
  The results of the present study support that perioperative blood transfusion of <5 units does not decrease survival in patients operated for spinal metastases. Transfusion of 1-2 units seems to be associated with increased 12-month survival. Future studies should assess if a liberal transfusion regime can be applied to this group of patients; thereby, prioritizing early postoperative mobilization.
authors.affiliation: Section of Cardiovascular Radiology, Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark, clausen.caroline@gmail.com.
authors.forename: Caroline
authors.initials: C
authors.lastname: Clausen
authors.forename: Lars
authors.initials: L
authors.lastname: Lönn
authors.forename: Søren Schmidt
authors.initials: SS
authors.lastname: Morgen
authors.forename: Michael Bachmann
authors.initials: MB
authors.lastname: Nielsen
authors.forename: Susanne Christiansen
authors.initials: SC
authors.lastname: Frevert
authors.forename: Pär Ingemar
authors.initials: PI
authors.lastname: Johansson
authors.forename: Benny
authors.initials: B
authors.lastname: Dahl
mesh_terms: D000368:Aged; D001803:Blood Transfusion / Q000401:mortality* / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011300:Preoperative Care / Q000401:mortality* / Q000639:trends; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000401:mortality* / Q000556:secondary / Q000601:surgery*; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome