Study Design. A retrospective review of 244 adult spine instrumentation and
fusion surgery cases (1994-1995) from one institution.
Objectives. To ascertain the predictors of blood transfusions for adult pat
ients undergoing different types of multilevel spine surgery.
Summary of Background Data. Blood loss and transfusion requirements during
and after multilevel spine surgeries have always been perceived as great. I
dentifying the predictors of blood transfusion with this type of surgery ma
y aid in reducing the amount of blood loss and the transfusion requirements
.
Methods. The charts of 244 adult patients who underwent multilevel spine su
rgery from January 1994 to July 1995 were retrospectively reviewed.
Results. A Targe percentage of patients required blood transfusion. The sig
nificant determinants for increased amounts of allogeneic red blood cell un
its transfused on the day of surgery using linear multiple regression model
ing were low preoperative hemoglobin concentration, tumor surgery, increase
d number of posterior levels surgically fused, history of pulmonary disease
, decreased amount of autologous blood available, and no use of the Jackson
table (R-2 = 0.63). The significant determinants for an increased amount o
f autologous red blood cell units transfused on the day of surgery using li
near multiple regression modeling were increased autologous red blood cells
available, low preoperative hemoglobin concentration, and increased number
of posterior levels surgically fused (R-2 = 0.60).
Conclusion. The need for transfusion is associated with multiple factors, s
uggesting that a multifaceted, integrated approach may be necessary to redu
ce this risk.