TY - JOUR
T1 - Is perioperative blood transfusion associated with postoperative thromboembolism or infection after metastatic spinal tumor surgery?
AU - Ryvlin, Jessica
AU - Javed, Kainaat
AU - la Garza Ramos, Rafael De
AU - Hamad, Mousa
AU - Essibayi, Muhammed Amir
AU - Gelfand, Yaroslav
AU - Murthy, Saikiran
AU - Yassari, Reza
N1 - Publisher Copyright:
© 2023 Elsevier B.V.
PY - 2023/12
Y1 - 2023/12
N2 - Study design: Retrospective cohort. Summary of background data: Patients with metastatic spine disease who undergo surgical intervention have a high risk of requiring red blood cell (RBC) transfusion. Perioperative transfusion has been independently associated with increased risk of venous thromboembolic (VTE) and infectious complications following orthopedic procedures and degenerative spinal intervention; however, literature within spine oncology is limited. Objective: To determine the association between perioperative RBC transfusion and postoperative VTE or infection following spinal tumor surgery. Methods: A total of 153 patients who underwent surgery for spinal metastases between April 2012 and April 2022 were included. Medical records were reviewed to identify RBC transfusion administered either intraoperatively or within 96 h following surgery. The primary endpoints were: 1) development of any VTE or 2) development of any infection within 30 days following surgery. Any VTE was defined as deep vein thrombosis or pulmonary embolism, and any infection was defined as pneumonia, meningitis, Clostridium difficile infection, urinary tract infection, surgical site infection, or sepsis. Logistic regression analyses were performed. Results: Of the 153 patients included in the study, 43 % received a perioperative RBC transfusion. The overall incidence of postoperative VTE and infection was 15 % and 22 %, respectively. In univariate analysis, perioperative transfusion was not associated with postoperative VTE (odds ratio [OR] 2.41; 95 % confidence interval [CI] 0.97–6.00; p = 0.058) but was associated with infection (OR 3.02; 95 % CI 1.36–6.73; p = 0.007). After adjusting for confounders such as performance status, operative time, and surgical extent, transfusion was not associated with both VTE (OR 1.25; 95 % CI 0.36–4.32; p = 0.727) or infection (OR 1.86; 95 % CI 0.70–4.92; p = 0.210). While not statistically significant, sub-analyses demonstrated a trend towards increased VTE incidence in patients requiring transfusion earlier (within 24 h) as opposed to later postoperatively. Conclusions: We found that perioperative transfusion was not an independent predictor of 30-day postoperative VTE or infection in patients undergoing metastatic spinal surgery. Further exploration of time-dependent transfusion outcomes is warranted.
AB - Study design: Retrospective cohort. Summary of background data: Patients with metastatic spine disease who undergo surgical intervention have a high risk of requiring red blood cell (RBC) transfusion. Perioperative transfusion has been independently associated with increased risk of venous thromboembolic (VTE) and infectious complications following orthopedic procedures and degenerative spinal intervention; however, literature within spine oncology is limited. Objective: To determine the association between perioperative RBC transfusion and postoperative VTE or infection following spinal tumor surgery. Methods: A total of 153 patients who underwent surgery for spinal metastases between April 2012 and April 2022 were included. Medical records were reviewed to identify RBC transfusion administered either intraoperatively or within 96 h following surgery. The primary endpoints were: 1) development of any VTE or 2) development of any infection within 30 days following surgery. Any VTE was defined as deep vein thrombosis or pulmonary embolism, and any infection was defined as pneumonia, meningitis, Clostridium difficile infection, urinary tract infection, surgical site infection, or sepsis. Logistic regression analyses were performed. Results: Of the 153 patients included in the study, 43 % received a perioperative RBC transfusion. The overall incidence of postoperative VTE and infection was 15 % and 22 %, respectively. In univariate analysis, perioperative transfusion was not associated with postoperative VTE (odds ratio [OR] 2.41; 95 % confidence interval [CI] 0.97–6.00; p = 0.058) but was associated with infection (OR 3.02; 95 % CI 1.36–6.73; p = 0.007). After adjusting for confounders such as performance status, operative time, and surgical extent, transfusion was not associated with both VTE (OR 1.25; 95 % CI 0.36–4.32; p = 0.727) or infection (OR 1.86; 95 % CI 0.70–4.92; p = 0.210). While not statistically significant, sub-analyses demonstrated a trend towards increased VTE incidence in patients requiring transfusion earlier (within 24 h) as opposed to later postoperatively. Conclusions: We found that perioperative transfusion was not an independent predictor of 30-day postoperative VTE or infection in patients undergoing metastatic spinal surgery. Further exploration of time-dependent transfusion outcomes is warranted.
KW - Metastasis
KW - Postoperative complications
KW - Spine surgery
KW - Transfusion
UR - http://www.scopus.com/inward/record.url?scp=85176950175&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85176950175&partnerID=8YFLogxK
U2 - 10.1016/j.clineuro.2023.108052
DO - 10.1016/j.clineuro.2023.108052
M3 - Article
C2 - 37980825
AN - SCOPUS:85176950175
SN - 0303-8467
VL - 235
JO - Clinical Neurology and Neurosurgery
JF - Clinical Neurology and Neurosurgery
M1 - 108052
ER -