Cristante Alexandre Fogaça, Borges Paulo Alvim, Barbosa Angelo Roberto, Letaif Olavo Biraghi, Marcon Raphael Martus, Barros Filho Tarcisio Eloy Pessoa de
Spine Division, (IOT-HCFMUSP), Instituto de Ortopedia e Traumatologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Clinics (Sao Paulo). 2014 Dec;69(10):672-6. doi: 10.6061/clinics/2014(10)04.
To evaluate the association of clinical and demographic variables in patients requiring blood transfusion during elective surgery to treat scoliosis with the aim of identifying markers predictive of the need for blood transfusion.
Based on the review of medical charts at a public university hospital, this retrospective study evaluated whether the following variables were associated with the need for red blood cell transfusion (measured by the number of packs used) during scoliosis surgery: scoliotic angle, extent of arthrodesis (number of fused levels), sex of the patient, surgery duration and type of scoliosis (neuromuscular, congenital or idiopathic).
Of the 94 patients evaluated in a 55-month period, none required a massive blood transfusion (most patients needed less than two red blood cell packs). The number of packs was not significantly associated with sex or type of scoliosis. The extent of arthrodesis (r = 0.103), surgery duration (r = 0.144) and scoliotic angle (r = 0.004) were weakly correlated with the need for blood transfusion. Linear regression analysis showed an association between the number of spine levels submitted to arthrodesis and the volume of blood used in transfusions (p = 0.001).
This study did not reveal any evidence of a significant association between the need for red blood cell transfusion and scoliotic angle, sex or surgery duration in scoliosis correction surgery. Submission of more spinal levels to arthrodesis was associated with the use of a greater number of blood packs.
评估择期手术治疗脊柱侧弯时需要输血的患者的临床和人口统计学变量之间的关联，旨在识别预测输血需求的标志物。
基于对一所公立大学医院病历的回顾，这项回顾性研究评估了以下变量是否与脊柱侧弯手术期间红细胞输血需求（以使用的血袋数量衡量）相关：脊柱侧弯角度、融合范围（融合节段数量）、患者性别、手术持续时间和脊柱侧弯类型（神经肌肉型、先天性或特发性）。
在55个月期间评估的94例患者中，无一人需要大量输血（大多数患者需要少于两袋红细胞）。血袋数量与性别或脊柱侧弯类型无显著关联。融合范围（r = 0.103）、手术持续时间（r = 0.144）和脊柱侧弯角度（r = 0.004）与输血需求呈弱相关。线性回归分析显示，接受融合的脊柱节段数量与输血使用的血量之间存在关联（p = 0.001）。
本研究未发现脊柱侧弯矫正手术中红细胞输血需求与脊柱侧弯角度、性别或手术持续时间之间存在显著关联的证据。接受融合的脊柱节段越多，血袋使用数量越多。
