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Transfusion of Red Blood Cells Stored More Than 28 Days is Associated With Increased Morbidity Following Spine Surgery.

Publication ,  Journal Article
Purvis, TE; Goodwin, CR; Molina, CA; Frank, SM; Sciubba, DM
Published in: Spine (Phila Pa 1976)
July 1, 2018

STUDY DESIGN: A retrospective study. OBJECTIVE: The aim of this study was to describe the association between storage duration of packed red blood cells (PRBCs) and perioperative adverse events in patients undergoing spine surgery at a tertiary care center. SUMMARY OF BACKGROUND DATA: Despite retrospective studies that have shown that longer PRBC storage duration worsens patient outcomes, randomized clinical trials have found no difference in outcomes. However, no studies have examined the impact of giving the oldest blood (28 days old or more) on morbidity within spine surgery. METHODS: The surgical administrative database at our institution was queried for patients transfused with PRBCs who underwent spine surgery between December 4, 2008, and June 26, 2015. Patients undergoing spinal fusion, tumor-related surgeries, and other identified spine surgeries were included. Patients were divided into two groups on the basis of storage duration of blood transfused: exclusively ≤28 days' storage or exclusively >28 days' storage. The primary outcome was composite in-hospital morbidity, which included (1) infection, (2) thrombotic event, (3) renal injury, (4) respiratory event, and/or (5) ischemic event. RESULTS: In total, 1141 patients who received a transfusion were included for analysis in this retrospective study; 710 were transfused exclusively with PRBCs ≤28 days' storage and 431 exclusively with PRBCs >28 days' storage. Perioperative complications occurred in 119 patients (10.4%). Patients who received blood stored for >28 days had higher odds of developing any one complication [odds ratio (OR) = 1.82; 95% confidence interval (95% CI), 1.20-2.74; P = 0.005] even after adjusting for competing perioperative risk factors. CONCLUSION: Blood stored for >28 days is independently associated with higher odds of developing perioperative complications in patients transfused during spinal surgery. Our results suggest that blood storage duration may be an appropriate parameter to consider when developing institutional transfusion guidelines that seek to optimize patient outcomes. LEVEL OF EVIDENCE: 3.

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Published In

Spine (Phila Pa 1976)

DOI

EISSN

1528-1159

Publication Date

July 1, 2018

Volume

43

Issue

13

Start / End Page

947 / 953

Location

United States

Related Subject Headings

  • Spinal Diseases
  • Risk Factors
  • Retrospective Studies
  • Postoperative Complications
  • Orthopedics
  • Morbidity
  • Middle Aged
  • Male
  • Humans
  • Female
 

Citation

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Purvis, T. E., Goodwin, C. R., Molina, C. A., Frank, S. M., & Sciubba, D. M. (2018). Transfusion of Red Blood Cells Stored More Than 28 Days is Associated With Increased Morbidity Following Spine Surgery. Spine (Phila Pa 1976), 43(13), 947–953. https://doi.org/10.1097/BRS.0000000000002464
Purvis, Taylor E., C Rory Goodwin, Camilo A. Molina, Steven M. Frank, and Daniel M. Sciubba. “Transfusion of Red Blood Cells Stored More Than 28 Days is Associated With Increased Morbidity Following Spine Surgery.Spine (Phila Pa 1976) 43, no. 13 (July 1, 2018): 947–53. https://doi.org/10.1097/BRS.0000000000002464.
Purvis TE, Goodwin CR, Molina CA, Frank SM, Sciubba DM. Transfusion of Red Blood Cells Stored More Than 28 Days is Associated With Increased Morbidity Following Spine Surgery. Spine (Phila Pa 1976). 2018 Jul 1;43(13):947–53.
Purvis, Taylor E., et al. “Transfusion of Red Blood Cells Stored More Than 28 Days is Associated With Increased Morbidity Following Spine Surgery.Spine (Phila Pa 1976), vol. 43, no. 13, July 2018, pp. 947–53. Pubmed, doi:10.1097/BRS.0000000000002464.
Purvis TE, Goodwin CR, Molina CA, Frank SM, Sciubba DM. Transfusion of Red Blood Cells Stored More Than 28 Days is Associated With Increased Morbidity Following Spine Surgery. Spine (Phila Pa 1976). 2018 Jul 1;43(13):947–953.

Published In

Spine (Phila Pa 1976)

DOI

EISSN

1528-1159

Publication Date

July 1, 2018

Volume

43

Issue

13

Start / End Page

947 / 953

Location

United States

Related Subject Headings

  • Spinal Diseases
  • Risk Factors
  • Retrospective Studies
  • Postoperative Complications
  • Orthopedics
  • Morbidity
  • Middle Aged
  • Male
  • Humans
  • Female