Appropriate Preoperative Blood Preparing and Risk factors Associated with Blood Transfusion in Patients Undergoing Elective Spine Surgery

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Apinya Kittiponghansa
Siwalai Sucher
Nitchakarn Luechanimitchit
Kittipong Wittayapairoj
Krittiya Wanphon
Ruttiyaporn Chumsri


Background: Elective spine surgery involves many techniques and often necessitates blood transfusion. The objective of the study is to evaluate the appropriateness of preoperative blood preparation for elective spine surgery and to identify risk factors that increased intraoperative blood requirements. Methods: A retrospective study was designed in all patients who underwent elective spine surgery from January 2020 to December 2021. The crossmatch to transfusion ratio (C:T ratio), transfusion probability (%T) and transfusion index (Ti) were collected. Results: A total of 901 patients were included, with blood preparation being carried out in 751 cases. Of these, 193 patients received transfusions. The C:T ratio was 2.5. The %T and Ti were 25.7 and 0.9, respectively. The procedures meeting the criteria for effective blood preparation included spinal tumor resection (metastasis), En bloc surgery, posterior instrumentation, and laminectomy with posterior instrumentation involving more than 3 spine levels. Conclusion: The incidence of RBC transfusion varies depending on the type of surgery. Factors associated with blood transfusion include low preoperative hematocrit, duration of operation time more than 180 minutes, involvement of more than 3 levels of surgical segments, and higher intraoperative blood loss.

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