Effect of liberal blood transfusion on clinical outcomes and cost in spine surgery patients.

摘要: Abstract Background Context Blood transfusions in spine surgery are shown to be associated with increased patient morbidity. The association between transfusion performed using a liberal hemoglobin trigger—defined as an intraoperative level of ≥10 g/dL, postoperative ≥8 or whole hospital nadir 8-10 g/dL—and perioperative morbidity and cost patients is unknown thus was investigated this study. Purpose To describe the outcomes economic trigger among patients. Study Design/Setting Retrospective Patient Sample surgical billing database at our institution queried for inpatients discharged 2008 2015 after following procedures: atlantoaxial fusion, anterior cervical posterior lumbar lateral other procedures, tumor-related surgeries. In total, 6931 were included analysis. Outcome Measures primary outcome composite which comprised of: (1) infection (sepsis, surgical-site infection, Clostridium dificile, drug-resistant infection), (2) thrombotic event (pulmonary embolus, deep venous thrombosis, disseminated intravascular coagulation), (3) kidney injury, (4) respiratory event, and/or (5) ischemic (transient attack, myocardial infarction, cerebrovascular accident). Methods Data on obtained from automated prospectively collected anesthesia data management system. through Web-based intelligence portal. Based previous research, we analyzed three definitions who received RBC transfusion: Hb 10 g/dL greater, 8 g/dL. Variables in-hospital morbidity, mortality, length stay, total costs strategy. Results Among stay transfused demonstrated longer (median [IQR], 6 [5-9] vs. 4 [3-6] days; P Conclusions Transfusion even controlling possible confounders. Our results suggest that modification practice may potential area improving reducing costs.