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Published in: Acta Neurochirurgica 7/2018

01-07-2018 | Original Article - Neurosurgical Techniques

Red blood cell transfusion probability and associated costs in neurosurgical procedures

Authors: Martin Barth, Christel Weiss, Kirsten Schmieder

Published in: Acta Neurochirurgica | Issue 7/2018

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Abstract

Background

The extent of red blood cell units (RBC) needed for different neurosurgical procedures and the time point of their administration are widely unknown, which results in generously cross-matching prior to surgery. However, RBC are increasingly requested in the aging western populations, and blood donations are significantly reduced. Therefore, the knowledge of the extent and time point of administration of RBC is of major importance.

Methods

This is a retrospective single center analysis. The incidence of RBC transfusion during surgery or within 48 h after surgery was analyzed for all neurosurgical patients within 3 years. Costs for cross-matched and transfused RBC were calculated and risk factors for RBC transfusion analyzed.

Results

The risk of intraoperative RBC administration was low for spinal and intracranial tumor resections (1.87%) and exceeded 10% only in spinal fusion procedures. This was dependent on the number of fused segments with an intraoperative transfusion risk of > 12.5% with fusion of more than three levels. Multiple logistic regression analysis showed a significantly increased risk for RBC transfusion for female gender (p = 0.006; OR 1.655), higher age (N = 4812; p < 0.0001; OR 1.028), and number of fused segments (N = 737; p < 0.0001; OR 1.433). Annual costs for cross-matching were 783,820.88 USD and for intraoperative RBC administration 121,322.13 USD.

Conclusions

Neurosurgical procedures are associated with a low number of RBC needed intraoperatively. Only elective spine fusion procedures with ≥ 3 levels involved and AVM resections seem to require cross-matching of RBC. The present data may allow changing the preoperative algorithm of RBC cross-matching in neurosurgical procedures and help to save resources and costs.
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Metadata
Title
Red blood cell transfusion probability and associated costs in neurosurgical procedures
Authors
Martin Barth
Christel Weiss
Kirsten Schmieder
Publication date
01-07-2018
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 7/2018
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-018-3516-x

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