BACKGROUND AND OBJECTIVES:Spine surgery frequently needs allogeneic blood transfusions to compensate for great blood loss. Autologous blood donations often are indicated to reduce homologous transfusions. In last decades interbody spinal fusion has gained popularity, being frequently performed in many spine procedures. Nevertheless, there are few studies evaluating the risk factors of additional blood transfusions in the postoperative course of degenerative spine surgery and no one concerning patients who underwent interbody fusion. MATERIALS AND METHODS:In 15 consecutive months, in the same Department of Spine Surgery 40 different elective spine surgeries were performed, divided into four groups: laminectomy alone, laminectomy with an instrumented posterolateral fusion, laminectomy with an instrumented posterolateral and interbody fusion, extensive instrumented fusion. All patients surgery-related data were respectively recorded: patient age, gender, diagnosis, preoperative hemoglobin rate, autologous blood availability, number of spinal level decompressed and fused, duration of surgery, type of surgical procedure, duration of hospital stay. These data were statistically analysed to determine whether variables could determine higher risk of blood transfusion. RESULTS:In an univariate analysis of factors influencing the need of blood transfusion, significantly greater risk of blood transfusions was observed in the female, in case of low preoperative Hb rate, longer surgical times, multiple spinal level decompressed or fused and longer duration of hospital stay. Our linear multiple regression modeling showed that patients gender and increased number of levels decompressed and levels surgically fused were significant determinants of need of blood transfusion. CONCLUSIONS:The practical value of this work can be particularly appreciated by those who are used to consider blood predonation. According to our findings blood predonation should preferably be proposed to women supposed to undergo spine instrumented fusion or a more than three levels spine decompression.

译文

背景与目的:脊柱外科手术经常需要进行同种异体输血,以弥补大量失血。自体献血通常被指示为减少同源输血。在最近的几十年中,椎间融合术已经普及,在许多脊柱手术中经常进行。然而,很少有研究评估变性脊柱手术术后额外输血的危险因素,并且没有人涉及接受椎间融合的患者。
材料与方法:连续15个月,在同一脊柱外科进行了40次不同的选择性脊柱外科手术,分为四组:单独的椎板切除术,经器械后外侧融合的椎板切除术,经器械后外侧和椎间融合的椎板切除术,广泛的器械融合。记录所有患者与手术有关的数据:患者年龄,性别,诊断,术前血红蛋白率,自体血液可用性,脊柱减压和融合的次数,手术时间,手术程序类型,住院时间。对这些数据进行统计分析,以确定变量是否可以确定较高的输血风险。
结果:对影响输血需求的因素进行单因素分析,发现女性术前血红蛋白率低,手术时间较长,多处脊柱减压或融合以及住院时间较长的情况下,女性输血的风险明显增加。停留。我们的线性多元回归模型显示,患者的性别和减压水平的增加数量以及手术融合的水平是需要输血的重要决定因素。
结论:那些习惯于考虑血液捐赠的人特别赞赏这项工作的实用价值。根据我们的发现,应该对应该进行脊柱器械融合术或三级以上脊柱减压的女性建议进行血液捐血。

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