School of Medicine and Health Sciences Poster Presentations
Nationwide Sampling for Blood Loss Requiring Transfusion in Elective Lumbar Fusion Procedures: An ACS-NSQIP Data Analysis
Poster Number
296
Document Type
Poster
Publication Date
3-2016
Abstract
In the United States, there are approximately 400,000 elective lumbar fusions performed annually according to the Healthcare Cost and Utilization Project. In elective lumbar fusion cases, a blood transfusion is considered a “hit” by centers participating in the American College of Surgeons – National Surgical Quality Improvement Program (ACS-NSQIP). Recognizing there is a shortage of banked blood nationwide, unnecessary transfusions should be avoided.
Using the ACS-NSQIP database from 2005-2012, we extracted all lumbar fusion cases using identifying CPT codes along with the primary data-point on patients receiving blood transfusions. Univariate and bivariate analysis were conducted and the Wilcoxon Mann-Whitney test was used to assess for statistical significance.
The results showed statistical significance for blood transfusion between orthopedic surgeons and neurosurgeons, 21% and 14% respectively. In analyzing the odds ratio for the fusion type and number of levels performed, we determined that osteotomy had the highest odds ratio of 6.24 (95% CI: 4.19-9.29) and two-level surgeries were associated with an almost 3-fold (OR: 2.92; 95% CI: 2.43-3.50) increased risk of blood transfusion while three-level surgeries were associated with a 3.7-fold (OR: 3.66; 95% CI: 3.21-4.18) increased risk relative to one-level surgeries.
Lumbar fusion surgery has an increased propensity of having a blood transfusion. Knowing the risk factors and improving surgical techniques will allow spine surgeons to judiciously utilize the depleting supply in the blood banks.
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Open Access
1
Nationwide Sampling for Blood Loss Requiring Transfusion in Elective Lumbar Fusion Procedures: An ACS-NSQIP Data Analysis
In the United States, there are approximately 400,000 elective lumbar fusions performed annually according to the Healthcare Cost and Utilization Project. In elective lumbar fusion cases, a blood transfusion is considered a “hit” by centers participating in the American College of Surgeons – National Surgical Quality Improvement Program (ACS-NSQIP). Recognizing there is a shortage of banked blood nationwide, unnecessary transfusions should be avoided.
Using the ACS-NSQIP database from 2005-2012, we extracted all lumbar fusion cases using identifying CPT codes along with the primary data-point on patients receiving blood transfusions. Univariate and bivariate analysis were conducted and the Wilcoxon Mann-Whitney test was used to assess for statistical significance.
The results showed statistical significance for blood transfusion between orthopedic surgeons and neurosurgeons, 21% and 14% respectively. In analyzing the odds ratio for the fusion type and number of levels performed, we determined that osteotomy had the highest odds ratio of 6.24 (95% CI: 4.19-9.29) and two-level surgeries were associated with an almost 3-fold (OR: 2.92; 95% CI: 2.43-3.50) increased risk of blood transfusion while three-level surgeries were associated with a 3.7-fold (OR: 3.66; 95% CI: 3.21-4.18) increased risk relative to one-level surgeries.
Lumbar fusion surgery has an increased propensity of having a blood transfusion. Knowing the risk factors and improving surgical techniques will allow spine surgeons to judiciously utilize the depleting supply in the blood banks.
Comments
Presented at: GW Research Days 2016