THE IMPACT OF BLOOD TRANSFUSION ON OUTCOMES IN POSTERIOR LUMBAR FUSION SURGERY

Abstract

Objective: Posterior lumbar fusion (PLF) is becoming increasingly common. One of the most critical aspects of these operations is the management of bleeding and blood products, which is of great importance for anesthetists and surgeons. The objective of this study was to examine the relationship between blood transfusion and complications after PLF surgery. The secondary objective was to identify risk factors associated with transfusion. Materials and Methods: The data from the PLF surgeries that were performed over a four-year period at a training and research hospital were subjected to a comprehensive retrospective analysis. A comprehensive examination of the following variables was conducted: age, comorbidities, laboratory values, anti-coagulant use, surgical and anesthetic notes, blood and blood product use, post-operative complications, and length of stay. Results: The study included 497 patients. The mean age of the patients was 60.78 years, the mean body mass index was 28.89, and the mean operation time was 3.63 hours. A total of 30.6% of patients received blood transfusions. Complications occurred in 10.1% of patients, and a higher prevalence was noted among those who received blood transfusions. The most common complication was sepsis. The likelihood of receiving blood transfusions was higher in patients who were older and female, had lower pre-operative hemoglobin (Hb) levels, underwent more fusions, experienced longer operative times, and had surgeries involving the sacral region. Logistic regression analysis identified preoperative low Hb levels, a greater number of fusions, and an extended operation duration as significant risk factors for blood transfusion. Conclusion: A higher incidence of complications was observed among patients undergoing PLF surgery who received blood transfusions. The implementation of improved pre-operative management of haemoglobin levels, along with more effective intraoperative transfusion practices, and reducing post-operative complications will lead to more favorable outcomes.