Park Si Young, Kang Taewook, Jeong Woong Kyo, Song Ji Eun
Department of Orthopedics, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
Department of Spine Surgery, Cheil Orthopedic Hospital, Seoul 06075, Republic of Korea.
J Clin Med. 2024 Aug 18;13(16):4867. doi: 10.3390/jcm13164867.
Retrospective cohort study. Effects of blood loss that requires blood transfusion after lumbar spinal fusion remain an important issue. Blood transfusions are used commonly in cases of significant blood loss in lumbar spinal fusion but are associated with adverse effects. The objective was to assess the rate of blood transfusion and the associated risk after lumbar spinal fusion from 2013 to 2018. In this nationwide population-based cohort study, the Korean Health Insurance Review and Assessment Service database was reviewed retrospectively from 2013 to 2018. Data were extracted from patients who underwent lumbar spinal fusion without history of lumbar spinal surgery in the preceding year. The primary outcome was the rate of blood transfusion within 1 week of surgery. In addition, the risk factors for blood transfusion and the rate of postoperative infection were evaluated. A total of 188,581 patients underwent lumbar spinal fusion between 2013 and 2018. A significant decline in blood transfusions was observed during the study period (56.38-47.51%). The presence of comorbidities was associated with an increased risk of blood transfusion. Patients who underwent the posterior approach were more likely to receive blood transfusion than patients who underwent the anterior or anterior and posterior approach. Receiving blood transfusion was associated with postoperative infection. In the present study, the prevalence, risk factors, and postoperative infection rates associated with blood transfusion in lumbar spinal fusion were identified. Spine surgeons should consider these risk factors in patients at high risk of blood transfusion.
回顾性队列研究。腰椎融合术后需要输血的失血影响仍是一个重要问题。输血在腰椎融合术中大量失血的情况下普遍使用，但会带来不良反应。目的是评估2013年至2018年腰椎融合术后的输血率及相关风险。在这项基于全国人群的队列研究中，对韩国健康保险审查与评估服务数据库进行了2013年至2018年的回顾性审查。数据提取自上一年无腰椎手术史且接受腰椎融合术的患者。主要结局是术后1周内的输血率。此外，还评估了输血的危险因素和术后感染率。2013年至2018年共有188,581例患者接受了腰椎融合术。在研究期间观察到输血率显著下降（从56.38%降至47.51%）。合并症的存在与输血风险增加相关。接受后路手术的患者比接受前路或前后路联合手术的患者更有可能接受输血。接受输血与术后感染相关。在本研究中，确定了腰椎融合术中与输血相关的患病率、危险因素和术后感染率。脊柱外科医生应在输血高风险患者中考虑这些危险因素。
