Dose-dependent effects of red blood cell transfusion and case mix index on venous thromboembolic events in spine surgery.
Vox Sang
; 118(1): 76-83, 2023 Jan.
Article
em En
| MEDLINE
| ID: mdl-36454545
ABSTRACT
BACKGROUND AND OBJECTIVES:
Venous thromboembolic (VTE) events represent a major source of morbidity and mortality in spine surgery. Our goal was to assess whether a dose-response relationship exists between red blood cell (RBC) transfusion and postoperative VTE events among spine surgery patients. MATERIALS ANDMETHODS:
A total of 786 spine surgery patients at a single institution who received at least 1 RBC unit perioperatively were included (2016-2019). Patients were stratified based on RBC transfusion volume 1-2 units (39.3%), 3-4 units (29.4%), 5-6 units (15.9%) and ≥7 units (15.4%). Subgroup analyses were performed after stratification by case mix index, a standardized surrogate for patients' disease severity and comorbidities. Multivariable regression was used to assess risk factors for the development of postoperative VTE events.RESULTS:
The overall VTE event rate was 2.4% (n = 19). A dose-response relationship was seen between RBC transfusion volume and VTE events (1-2 units 0.97%, 3-4 units 1.30%, 5-6 units 3.20%, ≥7 units 7.44%; p < 0.01). Similar dose-response relationships were seen between case mix index and VTE events (1.00-3.99 0.52%, 4.00-6.99 2.68%, ≥7.00 9.00%; p < 0.01). On multivariable regression, larger RBC transfusion volumes (adjusted odds ratio [OR] 1.18 per RBC unit, 95% confidence interval [CI] 1.07-1.29; p < 0.01) and higher case mix index scores (adjusted OR 1.39 per unit increase, 95% CI 1.14-1.69; p < 0.01) were associated with an increased risk of thrombosis.CONCLUSION:
Larger RBC transfusion volumes and higher case mix index scores were associated with an increased risk of VTE events. Physicians should be aware of how these dose-response relationships can influence a patient's risk of developing thrombotic complications postoperatively.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Tromboembolia Venosa
Tipo de estudo:
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Vox Sang
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Estados Unidos