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 Release 21.0, Jan 2008
 
Chapter : ch5. Transfusion Medicine Section : Estimation of Blood Loss and Prediction of Blood Transfusion Needs
  Risk Factors of Meert et al for Blood Transfusion in a Pediatric Patient Undergoing Spinal Fusion Surgery

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Overview :

Meert et al identified risk factors for blood transfusion in pediatric patients undergoing spinal fusion surgery. These can help identify a patient who may benefit from steps to reduce blood loss during surgery. The authors are the Children's Hospital of Michigan and Wayne State University in Detroit.

 

Age range: 1 to 20 years

 

Parameters:

(1) neuromuscular disease

(2) extent of spinal fusion

(3) body weight

 

Parameter

Finding

Points

neuromuscular disease

absent

0

 

present

1

number of vertebrae fused

few

0

 

multiple

1

body weight

intermediate to high

0

 

low

1

 

where:

• Low body weight may be due to younger age or being underweight for age.

 

number of risk factors for blood transfusion =

= SUM(points for all 3 parameters)

 

Interpretation:

• minimum number of risk factors: 0

• maximum number of risk factors: 3

• The risk of requiring a blood transfusion increases with the number of risk factors present.

• Autologous blood can be collected preoperatively, but many of the patients at risk are poor candidates for this practice.

 

  References:

Meert KL, Kannan S, Mooney JF. Predictors of red cell transfusion in children and adolescents undergoing spinal fusion surgery. Spine. 2002; 27: 2137-2142.

 

 

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