The efficacy and safety of blood and blood products in scoliosis surgery

Intraoperative blood loss during scoliosis surgery often leads to blood transfusion. Predictors of intraoperative blood loss, risk of transfusion and the postoperative effects of intraoperative blood loss and blood transfusion are extensively being investigated. In our study our primary aim was to investigate our habit and practice of using allogenic blood during scoliosis surgery. Our secondary aim was to investigate the influence of intraoperative blood transfusion on postoperative blood transfusion rate and postoperative outcomes. In this retrospective study 207 patients who have undergone scoliosis surgery between January 1st of 2009 and December 31th of 2014 were determined. Five of these patients were excluded from the study as we could not reach their records. In our study to investigate the perioperative transfusions and their effect on the patients in the postoperative period we recorded and investigated the following parameters; age, gender, body weight, ASA score, comorbid disease, fusion levels, operative and surgical times, preoperative hemoglobin levels, the hemoglobin levels just before the transfusion, intraoperative blood and blood product transfusion, intraoperative inotrope / vasopressor use, ICU and PACU time, time of mechanical ventilation, postoperative first hemoglobin levels, amount of intra/postoperative blood products transfusion and postoperative hospital stay times were recorded. Data of 138 women and 64 men were assessed. Patients were grouped according to the intraoperative allogenic blood transfusion usage. The mean operative times in the transfused group (n=116) was 339 (SD±98) minutes; and 193 (SD±106) minutes in the non-transfused group (n=86) (p ˂ 0,001). There were no difference between groups regarding fusion levels of ≤ 3, between 4-8 and ≥ 9 (p=0,104). The hospital discharge times of the intraoperative transfused patients were significantly longer than the non-transfused group (p<0,001). Postoperative blood transfusion rates were also significantly higher in patients in the intraoperative transfused group compared to non-transfused group (p<0,001). Postoperative mechanical ventilation times were significantly less in the non-transfused patients compared to the intraoperative transfused patients and only postoperative transfused patients (p˂0,001). In conclusion, our results reveal that intraoperative blood transfusions have a negative affect on early postoperative results. We can say that the perioperative strategies to decrease blood loss and transfusion of allogenic blood products in scoliosis surgery will be beneficial for our patients. Key words: Scoliosis surgery, allogenic blood transfusion.