Association of Intra-operative Blood Transfusions on Post-Operative Complications, 30-Day Readmission Rates, and One-Year Patient Reported Outcomes.
STUDY DESIGN: Ambispective cohort review OBJECTIVE.: To determine the effect of allogeneic Red Blood Cell (RBC) transfusion on post-operative patient complications profiles and 30-day readmission rates following elective spine surgery. SUMMARY OF BACKGROUND DATA: 30-day hospital readmission rates are being used as a proxy for quality of care. Intra- or peri-operative allogeneic RBC transfusions are associated with deleterious effects. Whether allogeneic RBC transfusions are associated with higher peri-operative complications and 30-day readmission rates after elective spine surgery remains unknown. METHODS: The medical records of 160 patients undergoing elective spine surgery at a major academic medical center were reviewed. Patient demographics, comorbidities, and post-operative complication rates were collected. All patients completed patient reported outcomes instruments (ODI, SF-36, and VAS-NP/BP/LP) before surgery, then at 3, 6, and 12-months after surgery. The association between intra- or peri-operative allogeneic RBC transfusions and 30-day readmission rate was assessed via multivariate logistic regression analysis. RESULTS: Baseline characteristics were similar in both cohorts. The mean pre- and post-operative hemoglobin levels were lower for the transfusion than non-transfusion cohorts. Post-operative complication rates were 44.67% and 23.00% in the transfusion and non-transfusion cohorts, respectively. Overall, 9.38% of patients were re-admitted within 30-days of hospital discharge, with a 3-fold higher increase in 30-day readmission rate in the transfusion cohort compared to the non-transfusion cohort (No transfusion: 5% vs. transfusion: 16.67%, p = 0.01). In a multivariate logistic regression model, intra- or peri-operative allogeneic RBC transfusion was an independent predictor of 30-day readmission after elective spine surgery (p = 0.005). CONCLUSION: Our study suggests that allogeneic Red Blood Cell transfusions may be associated with increased postoperative complications, length of hospital stay, and 30-day readmission rates. LEVEL OF EVIDENCE: 3.
Elsamadicy, AA; Adogwa, O; Vuong, VD; Mehta, AI; Vasquez, RA; Cheng, J; Bagley, CA; Karikari, IO
Pubmed Central ID
Electronic International Standard Serial Number (EISSN)
Digital Object Identifier (DOI)