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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2016

01-06-2016 | Neuro-Oncology

Blood Loss and Transfusion Requirements in Metastatic Spinal Tumor Surgery: Evaluation of Influencing Factors

Authors: Naresh Kumar, DM (Orth), Aye Sandar Zaw, MPH, Hnin Ei Khine, MBBS, Karthikeyan Maharajan, MRCS, Khin Lay Wai, MSc, Barry Tan, MRCS, Siti Mastura, MBBS, Raymond Goy, FANZCA

Published in: Annals of Surgical Oncology | Issue 6/2016

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Abstract

Background

Metastatic spine tumor surgery (MSTS) can be associated with significant blood loss. Previous studies did not provide comprehensive data on blood loss in MSTS. Thorough study elaborating the blood loss, transfusion requirement, and their influencing factors is required. This study aimed to investigate the estimated blood loss and transfusion requirements associated with various surgical approaches and surgically managed vertebral levels for spinal metastases from different primary tumors.

Methods

The study retrospectively evaluated 243 patients who underwent surgery for metastatic spine tumors at the authors’ institution between 2005 and 2014. Estimated intraoperative blood loss and transfusion requirement were assessed for different primary tumors including lung, breast, prostate, gastrointestinal, renal, liver, thyroid, myeloma/lymphoma, and others; types of surgical procedure (cervical corpectomy ± stabilization, thoracolumbar posterior decompression ± instrumentation, thoracolumbar corpectomy, minimally invasive surgery); and levels of instrumentation and decompression. Multivariate linear regression was attempted to investigate the factors influencing blood loss and transfusion requirements.

Results

The mean blood loss was 870 ± 720 ml, and the average blood transfusion was 1.5 ± 1.9 U. The mean blood loss was 1103 ml for patients who received blood transfusion and 597 ml for those who did not. Multivariate analysis showed that the significant factors influencing blood loss were primary tumor, type of surgery, and prolonged operative time. The influencing factors for blood transfusion were primary tumor, type of surgery, preoperative hemoglobin, and prolonged operative time.

Conclusions

Significant variations in blood loss and transfusion requirement were based on primary tumor of spinal metastases, surgical approaches, and operative time. These findings will help clinicians in preoperative planning to address the problem of blood loss during MSTS.
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Metadata
Title
Blood Loss and Transfusion Requirements in Metastatic Spinal Tumor Surgery: Evaluation of Influencing Factors
Authors
Naresh Kumar, DM (Orth)
Aye Sandar Zaw, MPH
Hnin Ei Khine, MBBS
Karthikeyan Maharajan, MRCS
Khin Lay Wai, MSc
Barry Tan, MRCS
Siti Mastura, MBBS
Raymond Goy, FANZCA
Publication date
01-06-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 6/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5092-8

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