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Short term outcomes associated with patients requiring blood transfusion following elective laminectomy and fusion for lumbar stenosis: A propensity-matched analysis – Lumbar Spinal Stenosis

In a large cohort study, researchers evaluated the impact of perioperative blood transfusion on outcomes in patients who underwent fusion for lumbar stenosis. The study included 16,329 patients, of which 11.8% received a transfusion. Before matching, there were several differences in baseline characteristics between transfused and non-transfused patients. However, after matching, no significant differences remained. In the matched cohorts, blood transfusion was associated with increased odds of prolonged length-of-stay, complications (both minor and major), discharge to a facility, readmission, and reoperation within 30 days. The study suggests the importance of balancing the risks and benefits of perioperative blood transfusion

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : innovative day surgery hospital on Harley Street UK

Published article

Perioperative blood transfusion has been associated with poor outcomes but the impacts of transfusion after fusion for lumbar stenosis have not been well-described. We assessed this effect in a large cohort of patients from 2012 to 2018 in the National Surgical Quality Improvement Program (NSQIP). We evaluated baseline characteristics including demographics, comorbidities, hematocrit, and operative characteristics. We generated propensity scores using baseline characteristics and patients were…

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J Clin Neurosci. 2021 Aug;90:184-190. doi: 10.1016/j.jocn.2021.05.061. Epub 2021 Jun 10.ABSTRACTPerioperative blood transfusion has been associated with poor outcomes but the impacts of transfusion after fusion for lumbar stenosis have not been well-described. We assessed this effect in a large cohort of patients from 2012 to 2018 in the National Surgical Quality Improvement Program (NSQIP).,

J Clin Neurosci. 2021 Aug;90:184-190. doi: 10.1016/j.jocn.2021.05.061. Epub 2021 Jun 10.

ABSTRACT

Perioperative blood transfusion has been associated with poor outcomes but the impacts of transfusion after fusion for lumbar stenosis have not been well-described. We assessed this effect in a large cohort of patients from 2012 to 2018 in the National Surgical Quality Improvement Program (NSQIP). We evaluated baseline characteristics including demographics, comorbidities, hematocrit, and operative characteristics. We generated propensity scores using baseline characteristics and patients were matched to approximate randomization. We assessed odds of 30-day outcomes including prolonged length-of-stay (LOS), complications, discharge to facility, readmission, reoperation, and death using logistic regression. We identified 16,329 eligible patients who underwent lumbar fusion for stenosis; 1,926 (11.8%) received a transfusion. Before matching, there were multiple differences in baseline covariates including age, gender, BMI, ASA class, medical comorbidities, hematocrit, coagulation indices, platelets, operative time, fusion technique, number of levels fused, and osteotomy. However, after matching, no significant differences remained. In the matched cohorts, transfusion was associated with increased prolonged LOS (OR 1.66, 95% CI 1.45-1.91, p < 0.001), minor complication (OR 1.60, 95% CI 1.20-2.12, p = 0.001), major complication (OR 1.51, 95% CI 1.16-1.98, p = 0.003), any complication (OR 1.54, 95% CI 1.24-1.92, p < 0.001), discharge to facility (OR 1.70, 95% CI 1.48-1.95, p < 0.001), 30-day readmission (OR 1.56, 95% CI 1.23-1.99, p < 0.001), and 30-day reoperation (OR 1.85, 95% CI 1.35-2.53, p < 0.001). Although transfusion is performed based on perceived clinical need, this study contributes to growing evidence that it is important to balance the risks of perioperative blood transfusion with its benefits.

PMID:34275547 | DOI:10.1016/j.jocn.2021.05.061

The London Spine Unit : innovative day surgery hospital on Harley Street UK

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Short term outcomes associated with patients requiring blood transfusion following elective laminectomy and fusion for lumbar stenosis: A propensity-matched analysis

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J Clin Neurosci. 2021 Aug;90:184-190. doi: 10.1016/j.jocn.2021.05.061. Epub 2021 Jun 10.ABSTRACTPerioperative blood transfusion has been associated with poor outcomes but the impacts of transfusion after fusion for lumbar stenosis have not been well-described. We assessed this effect in a large cohort of patients from 2012 to 2018 in the National Surgical Quality Improvement Program (NSQIP).

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