Efficacy of Preoperative Autologous Blood Donation for Surgical Treatment of Thoracic Spinal Stenosis: A Propensity-Matched Cohort Study.

Autor: Qi J; Department of Orthopedics, Peking University Third Hospital, Beijing, China.; Engineering Research Center of Bone and Joint Precision Medicine, Beijing, China.; Beijing Key Laboratory of Spinal Disease Research, Beijing, China., Hu Y; Department of Orthopedics, Peking University Third Hospital, Beijing, China.; Engineering Research Center of Bone and Joint Precision Medicine, Beijing, China.; Beijing Key Laboratory of Spinal Disease Research, Beijing, China., Niu X; Department of Orthopedics, Peking University Third Hospital, Beijing, China.; Engineering Research Center of Bone and Joint Precision Medicine, Beijing, China.; Beijing Key Laboratory of Spinal Disease Research, Beijing, China., Dong Y; Department of Orthopedics, Peking University Third Hospital, Beijing, China.; Engineering Research Center of Bone and Joint Precision Medicine, Beijing, China.; Beijing Key Laboratory of Spinal Disease Research, Beijing, China., Zhang X; Information Management and Big Data Center, Peking University Third Hospital, Beijing, China., Xu N; Department of Orthopedics, Peking University Third Hospital, Beijing, China.; Engineering Research Center of Bone and Joint Precision Medicine, Beijing, China.; Beijing Key Laboratory of Spinal Disease Research, Beijing, China., Chen Z; Department of Orthopedics, Peking University Third Hospital, Beijing, China.; Engineering Research Center of Bone and Joint Precision Medicine, Beijing, China.; Beijing Key Laboratory of Spinal Disease Research, Beijing, China., Li W; Department of Orthopedics, Peking University Third Hospital, Beijing, China.; Engineering Research Center of Bone and Joint Precision Medicine, Beijing, China.; Beijing Key Laboratory of Spinal Disease Research, Beijing, China., Tian Y; Department of Orthopedics, Peking University Third Hospital, Beijing, China.; Engineering Research Center of Bone and Joint Precision Medicine, Beijing, China.; Beijing Key Laboratory of Spinal Disease Research, Beijing, China., Sun C; Department of Orthopedics, Peking University Third Hospital, Beijing, China.; Engineering Research Center of Bone and Joint Precision Medicine, Beijing, China.; Beijing Key Laboratory of Spinal Disease Research, Beijing, China.
Jazyk: angličtina
Zdroj: Orthopaedic surgery [Orthop Surg] 2024 Dec; Vol. 16 (12), pp. 3068-3077. Date of Electronic Publication: 2024 Oct 02.
DOI: 10.1111/os.14249
Abstrakt: Objective: Thoracic spinal stenosis (TSS) surgeries necessitate a substantial amount of allogeneic blood resources. However, the efficacy of preoperative autologous blood donation (PABD) in TSS surgery has not been clearly evaluated. Therefore, we aimed to evaluate the efficacy of PABD for TSS surgery.
Methods: This study is a retrospective study. Totally 397 patients who underwent TSS surgeries at our institution from January 2019 to June 2023 were included. Propensity score matching (PSM) was used to make the PABD and Non-PABD groups comparable at baseline. Regarding outcome measures, the incidence and amount of allogeneic blood transfusion, changes in postoperative hemoglobin and hematocrit levels, occurrence of postoperative complications, medical costs, drainage time, length of hospital stay, and postoperative neurological function were analyzed. The outcomes were compared between the matched PABD (n = 79) and Non-PABD (n = 79) groups. Univariate analysis methods were used for statistical analysis, including independent samples t-test, Wilcoxon rank-sum test, and chi-square test.
Results: The incidence of allogeneic blood transfusion (8.9% vs. 25.3%, p = 0.006) and volume of intraoperative red blood cell (RBC) transfusion (10.12 ± 54.52 vs. 122.78 ± 275.00 mL, p < 0.001) in the PABD group were significantly lower than those in the Non-PABD group. The PABD group had significantly higher average postoperative hemoglobin and hematocrit levels than the Non-PABD group at 1, 3, and 5 days after surgery (p < 0.05). Similarly, the PABD group exhibited a smaller reduction in hemoglobin and hematocrit levels compared with the Non-PABD group on 1, 3, and 5 days postoperatively. There were no significant intergroup differences in terms of transfusion-related complications, medical expenses, neurological function, length of hospital stay, or drainage time. Notably, PABD was an independent protective factor of allogeneic transfusion in the multivariate regression analysis (OR = 0.334, 95%CI = 0.051-0.966).
Conclusions: PABD can effectively reduce the incidence of allogeneic blood transfusion and amount of allogeneic blood in TSS surgeries with safety. It also significantly improved the postoperative hemoglobin and hematocrit levels. Under the premise of clear indications, PABD is worth promoting for the surgical treatment of TSS.
(© 2024 The Author(s). Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
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