Scientists at Northwestern Medicine developed a new model for predicting blood transfusion during spine surgery and published their findings in the Journal of Neurosurgical Anesthesiology.
The researchers examined data from 548 patients who underwent three- or fewer-level posterior spinal fusion with instrumentation. The information was gathered from 2003 to 2009 and analyzed to predict major blood transfusion. Then, the model was tested with 95 separate patients for validity.
The researchers found a 59.5 percent incidence of major transfusion in the derivation set of patients and identified major transfusion predictors are:
• Operation duration
• Number of posterior levels instrumented
• Surgical complexity score
• Preincision hemoglobin
The new model predicted major transfusion significantly better than previously published models, according to the study abstract.
"Our model has increased accuracy for predicting the probability of major transfusion compared with a previously published model," concluded the study authors. "In addition, our model is applicable to all types of spine fusion surgery and accounts for the complexity of surgical instrumentation, the number of levels instrumented and the predicted duration of surgery as independent variables."
In a HealthData Management report, first author Louanne Carabini, MD, explained the findings can help justify preoperative testing, preparedness and intraoperative management being cost-effective with a risk-benefit analysis.