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Incidence and cost of perioperative red blood cell transfusion for elective spine fusion in a high-volume center for spine surgery

By G. Ristagno, S. Beluffi, G. Menasce, D. Tanzi, J. Pastore, G. D&apos, F. Belloli and G. Savoia

Abstract

Background: Spine fusion is a surgical procedure characterized by a significant perioperative bleeding, which often requires red blood cell (RBC) transfusion. Methods: The incidence and the cost of RBC transfusion were evaluated in all patients undergoing elective surgery for spine fusion in our Institution, a high-volume center for spine surgery, over a period of 3 years. The analysis specifically addressed the RBC transfusion need in all the different spine fusion procedures (atlanto-axial, cervical, dorsal, lumbar, revisions) with the different surgical approaches (anterior, posterior). Results: During the 3 years of observation, a total of 1.882 elective spine fusions were performed. More than half of the procedures (n = 964) were posterior lumbar fusions. Overall, 5% of the patients (n = 103) required RBC transfusion. The cervical fusions were the procedures with the lowest percentage of RBC need (0-5%), while the dorsal and the lumbar ones, with the anterior approach, represented the procedures with the highest rate of transfusion (29% and 25% respectively). More than 60 % of the RBC units were employed in the instance of posterior lumbar fusion, while a variable 1-10% of the units was used in each of the other procedures. The overall transfusion cost was of 46.000 euros, with a distribution of costs that paralleled the amount of units transfused for each procedure. Conclusions: Several surgical and patient factors may contribute to the perioperative blood loss. An accurate patient blood management, may efficiently decrease transfusion requirements and ultimately healthcare costs

Topics: pine fusion, transfusion, blood, costs, Settore MED/41 - Anestesiologia
Publisher: 'Springer Science and Business Media LLC'
Year: 2018
DOI identifier: 10.1186/s12871-018-0591-8
OAI identifier: oai:air.unimi.it:2434/618328

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