A new study published in Spine examined the risk factors for blood transfusion with primary posterior lumbar fusion.
The researchers examined the American College of Surgeons National Surgical Quality Improvement Program databases. There were 4,223 patients included in the study and 16.7 percent had blood transfusions. The risk factors included:
1. Patients 70 years old or older
2. American Society of Anesthesiologists class III or greater
3. Female patients
4. Pulmonary disease
5. Preoperative hematocrit less than 36
6. Operative time of 210 minutes or more
7. Two or more level procedures
8. Complications
9. Sepsis
10. Returning to the operating room
11. Surgical site infection
12. Pulmonary embolism
Blood transfusion was associated with increased postoperative length of stay of 1.4 days. The patients who underwent interbody fusion were associated with a lower rate of blood transfusions.