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논문 기본 정보

자료유형
학술저널
저자정보
Ahmed Aoude (McGill University Health Centre) Sultan Aldebeyan (McGill University Health Centre) Maryse Fortin (McGill University Health Centre) Anas Nooh (King Abdulaziz University) Peter Jarzem (McGill University Health Centre) Jean A. Ouellet (McGill University Health Centre) Michael H. Weber (McGill University Health Centre)
저널정보
대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.11 No.6
발행연도
2017.1
수록면
880 - 891 (12page)

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Study Design: Retrospective cohort study. Purpose: The purpose of this study was to assess the rate of blood transfusion after cervical fusion surgery, and its effect on complication rates. Overview of Literature: Cervical spine fusions have gained interest in the literature since these procedures are now ever more frequently being performed in an outpatient setting with few complications. Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was used to identify patients that underwent cervical fusion from 2010 to 2013. Multivariate regression analysis was used to determine postoperative complications associated with transfusion and cervical fusion. Results: We identified 11,588 patients who had cervical fusion between 2010 and 2013. The rate of blood transfusion following cervical fusion found to be 1.47%. All transfused patients were found to have increased risk of venous thromboembolism (TBE) (odds ratio [OR], 3.19; 95% confidence interval [95% CI], 1.16–8.77), myocardial infarction (MI) (OR, 9.12; 95% CI, 2.53–32.8), increased length of stay (LOS) (OR, 28.03; 95% CI, 14.28–55.01) and mortality (OR, 4.14; 95% CI, 1.44–11.93). Single level fusion had increased risk of TBE (OR, 3.37; 95% CI, 1.01–11.33), MI (OR, 10.5; 95% CI, 1.88–59.89), and LOS (OR, 14.79; 95% CI, 8.2–26.67). Multilevel fusion had increased risk of TBE (OR, 5.64; 95% CI, 1.15–27.6), surgical site infection (OR, 16.29; 95% CI, 3.34–79.49), MI (OR, 10.84; 95% CI, 2.01–58.55), LOS (OR, 26.56; 95% CI, 11.8–59.78), and mortality (OR, 10.24; 95% CI, 2.45–42.71). Patients who had anterior cervical discectomy and fusion surgery and received a transfusion had an increased risk of TBE (OR, 4.87; 95% CI, 1.04–22.82), surgical site infection (OR, 9.73; 95% CI, 2.14–44.1), MI (OR, 9.88; 95% CI, 1.87–52.2), increased LOS of more than 2 days (OR, 28.34; 95% CI, 13.79–58.21) and increase in mortality (OR, 6.3; 95% CI, 1.76–22.48). While, transfused patients who had posterior fusion surgery had increased risk of MI (OR, 10.45; 95% CI, 1.42–77.12) and increased LOS of more than 6 days (OR, 4.42; 95% CI, 2.68–7.29). Conclusions: Our results demonstrate that although cervical fusions can be done as outpatient procedures special precautions and investigations should be done for patients who receive transfusion after cervical fusion. These patients are demonstrated to have higher rate of MI, TBE, wound infection and mortality when compared to those who do not receive transfusion.

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참고문헌 (2)

참고문헌 신청
Blumberg N / 1997 / Allogeneic transfusion and infection: economic and clinical implications / Semin Hematol 34(3 Suppl 2):34~40 google schola Alam MM / 2013 / Primary elective spine arthrodesis: Audit of institutional cross matched to transfused (C/T) ratio to develop blood product ordering guidelines / Surg Neurol Int 4(Suppl 5):S368~S372 google schola

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