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Overview :
Berenholtz et al identfiied preoperative factors associated
with the use of blood products during or after spinal surgery. The authors are
from the Johns Hopkins University in Baltimore.
Predictors for use of any allogeneic blood product (red blood
cells, fresh frozen plasma, and/or platelets):
(1) age >= 54 years (risk greater if > 66 years)
(2) female gender
(3) diabetes mellitus with long-term complications
(4) metastates from a solid tumor
(5) admission from the Emergency Department
(6) greater hospital volume (> 187 cases per year)
The transfusion of red blood cells (allogeneic and
autologous) represented the vast majority of cases so tended to dominate the
statistics.
Predictors of red blood cell transfusion:
(1) age >= 54 years (risk greater if > 66 years of
age)
(2) female gender
(3) diabetes with complications
(4) metastases from a solid tumor
(5) greater hospital volume (> 187 cases per year)
(6) surgeon performing > 25 cases per year
Predictors for the use of autologous red blood cell
transfusion:
(1) white race
(2) female gender
(3) greater surgeon volume (> 53 cases per year)
Predictors for use of fresh frozen plasma (FFP):
(1) female gender
(2) diabetes, mild to moderate
(3) greater hospital volume (> 85 cases per year)
(4) greater surgeon volume (> 53 cases per year)
Predictors for the use of platelets:
(1) liver disease, mild
(2) renal disease
(3) malignancy (not necessarily metastatic)
(4) greater hospital volume (> 187 cases per year)
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