title: Risk factors for intraoperative allogeneic blood transfusion during craniotomy for brain tumor removal in children.
abstract: BACKGROUND
  Several clinical and surgical factors can influence the occurrence of allogeneic blood transfusion (ABT) during oncologic neurosurgery.
  
  
  OBJECTIVE
  To identify the potential predictive factors of ABT during craniotomy for the removal of brain tumors in children and the potential impact of intraoperative ABT on early postoperative outcome.
  
  
  METHODS
  A retrospective study was performed in all pediatric patients younger than 18 years who underwent craniotomy for brain tumor removal from December 2009 to December 2012 in our institution. Pre-, intra-, and postoperative data were collected from medical and stored electronic anesthesia records. The predictors of intraoperative ABT were determined using multivariate logistic regression.
  
  
  RESULTS
  A total of 110 patients were included. Twenty-seven patients (25%) received intraoperative ABT with a volume of 16 ± 8 ml·kg(-1) . On multivariate analysis, an age <4 years, a duration of surgery >270 min, and a preoperative hemoglobin <12.2 g·dl(-1) were independently associated with the need for intraoperative ABT. We did not show any significant difference concerning postoperative early outcome and length of stay between the transfused and non-transfused patients except for the duration of postoperative mechanical ventilation that was significantly higher in the transfused group (P = 0.04).
  
  
  CONCLUSIONS
  In children, craniotomy for brain tumor removal is at risk of intraoperative ABT. An age <4 years, a duration of surgery >270 min, and a preoperative hemoglobin <12.2 g·dl(-1) are the main factors associated with intraoperative ABT during this surgery.
authors.affiliation: Department of Pediatric Anesthesia, Femme Mère Enfant Teaching Hospital, Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon, France.
authors.forename: Olivia
authors.initials: O
authors.lastname: Vassal
authors.affiliation: Department of Pediatric Anesthesia, Femme Mère Enfant Teaching Hospital, Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon, France.
authors.forename: François-Pierrick
authors.initials: FP
authors.lastname: Desgranges
authors.affiliation: Department of Pediatric Anesthesia, Femme Mère Enfant Teaching Hospital, Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Tosetti
authors.affiliation: Department of Pediatric Anesthesia, Femme Mère Enfant Teaching Hospital, Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Burgal
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, Pierre Wertheimer Hospital, Hospices Civils de Lyon, Lyon, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Dailler
authors.affiliation: Department of Pediatric Intensive Care Unit, Femme Mère Enfant Teaching Hospital, Hospices Civils de Lyon, Lyon, France.
authors.forename: Etienne
authors.initials: E
authors.lastname: Javouhey
authors.affiliation: Department of Pediatric Neurosurgery, Pierre Wertheimer Hospital, Hospices Civils de Lyon, Lyon, France.
authors.forename: Carmine
authors.initials: C
authors.lastname: Mottolese
authors.affiliation: Department of Pediatric Anesthesia, Femme Mère Enfant Teaching Hospital, Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Chassard
mesh_terms: D016063:Blood Loss, Surgical / Q000706:statistics & numerical data*; D001804:Blood Transfusion, Autologous / Q000706:statistics & numerical data*; D001921:Brain / Q000601:surgery; D001932:Brain Neoplasms / Q000453:epidemiology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003399:Craniotomy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology*; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors
keywords: brain tumor; child; intraoperative; logistic regression; outcome; transfusion