Description
Title: Blood Management and Transfusion Risk Assessment in Children’s Spinal Deformity Surgery
Abstract: Objectives. Determine the risk factors for transfusion while assessing the effect of a Quality and Safety Program (QSP) on the decrease in blood loss and transfusion requirements in pediatric spinal deformity surgery. Background. In spinal deformity surgery, a multimodal plan aiming to reduce transfusion requirements has been shown to lower transfusions and index rates. Anticipating blood loss and transfusions may encourage reconsideration of the surgical plan or help focus resources on patient needs. Methods. is a single-center retrospective analysis of data that was collected prospectively. Both before and after QSP, the effects of this multimodal plan were examined on scoliosis associated with syndromic, neuromuscular, and muscular dystrophies (Group B, 100 patients), as well as idiopathic deformities (Group A, 109 patients). Results. The estimated total amount of blood loss decreased. Transfused patients dropped from 83.7% to 28% in Group A (p 0.001, odds: 0.077) and from 98.7% to 66% in Group B (p 0.01, odds: 0.038). The patient’s body weight and Cobb angle were found to be associated with blood loss by Pearson’s correlation (r 0.245, p 0.001, and r 0.175, p 0.017, respectively). Only body weight and transfusion demonstrated predictive power in a linear regression model used to estimate hematic losses, leading to a low predictive model (R2 0.156; F(3,167) 15.483, p 0.001). On the basis of a number of factors influencing transfusion, which is connected to blood loss, a mediated model to explain blood loss was developed. Conclusion. Following a multimodal approach, transfusion needs in scoliosis surgery can be significantly decreased. The introduction of a risk assessment tool for transfusion needs indirectly assesses surgical risk, allowing resource relocation to reduce blood loss. The success of a program is strongly dependent on teamwork.
Paper Quality: SCOPUS / Web of Science Level Research Paper
Subject: Medicine
Sub Category: Hematology
Writer Experience: 20+ Years
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