Predictors Of Intraoperative Washed Autologous Blood Re-infusions In Spine Surgery

Objective:The purpose of this study is to ascertain the predictors of intraoperative washed autologous blood re-infusions (IABR) for adult patients undergoing spine surgery from five institutions.Methods:A retrospective study of1331adult patients who underwent spine surgery from September2011to December2012was performed. We explored the factors with strongest independent association with IABR during the intraoperative using binary logistic regression analysis,and also the rates of allogeneic red blood cell transfusion and postoperative blood loss were determined.Results:1331cases were studied. There were621females and710males, with a mean age of50.87yeasr. Of the1331cases,64.1%patients had intraoperative cell salvage (IOCS) available, of whom only77.4%patients had autologous erythrocyte re-infused (mean re-infusion volume549ml). According to the binary logistic regression analysis, anterior approach of surgical,(odds ratio[OR]=10.524)the number of spine internal fixation is4or more([OR]=12.996), the number of spine fusion levels is3or more([OR]=10.836) and the number of decompression is2or more([OR]=50.434) were independent predictors for the IABR. Patients who had IABR had a higher rates of intraoperative and postoperative allogeneic erythrocyte transfusion compared with those who did not(25.8%vs6.5%and25.6%vs12.1%). There was no significant difference in the blood loss between patients who did and did not have IABR.Conclusion:Anterior approach of surgical, the number of spine internal fixation is4or more, the number of spine fusion levels is3or more and the number of decompression is2or more result in increased use of IABR. The patient who has use of IAER still had a high rate of intraoperative and postoperative allogeneic RBC transfusion.