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. 2021 Jan 5;22(1):13.
doi: 10.1186/s12891-020-03869-z.

Risk factors for blood transfusion in adolescent patients with scoliosis undergoing scoliosis surgery: a study of 722 cases in a single center

Yulei Dong  1 , Ning Tang  1 , Shengru Wang  1 , Jianguo Zhang  1 , Hong Zhao  2
Affiliations

Risk factors for blood transfusion in adolescent patients with scoliosis undergoing scoliosis surgery: a study of 722 cases in a single center

Yulei Dong et al. BMC Musculoskelet Disord. .

Abstract

Background: To assess the risk factors for blood transfusion in a great number of adolescent cases with different types of scoliosis who received scoliosis surgery.

Methods: Data of patients who were diagnosed as scoliosis and received one-stage posterior correction and spinal fusion from January 2014 to December 2017 were prospectively collected and retrospectively analyzed. Patients' demographic characteristics, segments of spinal fusion, Cobb angle of the major curve,osteotomy pattern, preoperative and postoperative levels of hemoglobin, and allogeneic blood transfusion (ABT) were recorded and analyzed.

Results: In this study, 722 cases with adolescent scoliosis were included, of whom 32.8% (237/722) received ABT. Risk factors included diagnosis: neurofibromatosis (OR = 5.592), syndromic (OR = 3.029),osteotomy: Ponte osteotomy (OR = 5.997), hemivertebrae resection (OR = 29.171), pedicle subtraction osteotomy (PSO)(OR = 8.712), vertebral column resection (VCR)(OR = 32.265);fusion segments (OR = 1.224) and intraoperative blood loss (OR = 1.004). In the subgroup analysis of cases with idiopathic scoliosis, Ponte osteotomy (OR = 6.086), length of segments of spinal fusion (OR = 1.293), and intraoperative blood loss (OR = 1.001) were found as risk factors for ABT. Results of receiver operating characteristic (ROC) curve analysis revealed that length of segments of spinal fusion equal to 11.5 vertebrae was the best cutoff value for cases with idiopathic scoliosis who did not receive osteotomy in both ABT group and non-ABT group. In the subgroup analysis of congenital scoliosis, Ponte osteotomy (OR = 5.087), hemivertebra resection (OR = 5.457), PSO (OR = 4.055), VCR (OR = 6.940), and intraoperative blood loss (OR = 1.004) were risk factors for ABT.

Conclusions: Method of diagnosis, osteotomy pattern, segments of spinal fusion, and intraoperative blood loss were risk factors for ABT in cases with adolescent scoliosis. In cases with idiopathic scoliosis, Ponte osteotomy and segments of spinal fusion longer than 11.5 vertebrae were risk factors for ABT. In cases with congenital scoliosis, osteotomy pattern was the main risk factor for ABT.

Level of evidence: Level III.

Keywords: Blood transfusion; Osteotomy; Scoliosis; Spine fusion.

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Conflict of interest statement

NA

Figures

Fig. 1
Fig. 1
The relationship between blood transfusion rate and method of diagnosis. There were more cases with congenital scoliosis in ABT group compared to non-ABT group, while there was a greater proportion of cases with idiopathic scoliosis in non-ABT group than that in ABT group
Fig. 2
Fig. 2
The relationship between blood transfusion rate and osteotomy pattern. There were a larger proportion of cases who received osteotomy in ABT group compared to non-ABT group
Fig. 3
Fig. 3
Subgroup analysis was carried out in patients with idiopathic scoliosis who received fusion surgery without osteotomy. ROC curve analysis revealed that in fused segments, 11.5 vertebrae was the best cutoff value in ABT group and non-ABT group (sensitivity, 72.1%; specificity, 64.5%)
See this image and copyright information in PMC

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