Association between preoperative hemoglobin levels after iron supplementation and perioperative blood transfusion requirements in children undergoing scoliosis surgery

Autor:	Nadia Naraine, Mark J. McVey, David Faraoni, Christian Zaarour, Racha Chamlati, Wendy Lau, Timothy Switzer
Rok vydání:	2020
Předmět:	medicine.medical_specialty Blood transfusion Anemia Iron medicine.medical_treatment Blood Loss Surgical Scoliosis Logistic regression Hemoglobins medicine Humans Blood Transfusion Dosing Child Retrospective Studies business.industry Perioperative medicine.disease Surgery Spinal Fusion Anesthesiology and Pain Medicine Spinal fusion Dietary Supplements Pediatrics Perinatology and Child Health Etiology business
Zdroj:	Pediatric Anesthesia. 30:1077-1082
ISSN:	1460-9592 1155-5645
DOI:	10.1111/pan.13987
Popis:	In this study, we assessed the association between preoperative hemoglobin and red blood cell transfusion in children undergoing spine surgery after the implementation of our preoperative iron supplementation protocol.We performed a retrospective analysis of patients who underwent posterior spinal fusion surgery between January 2013 and December 2017 and received preoperative iron supplementation. We used uni- and multivariable logistic regression to determine the association between preoperative hemoglobin level and red blood cell transfusion in patients receiving iron supplementation.A total of 382 patients treated with preoperative oral iron were included. Of these, 175 (45.5%) patients were transfused intraoperatively. Multivariable logistic regression analysis revealed nonidiopathic etiology of the scoliosis (OR 4.178 [95% CI: 2.277-7.668], P .001), the Cobb angle (OR 1.025 [95% CI: 1.010-1.040], P = .001), and number of vertebrae fused (OR 1.169 [95% CI: 1.042-1.312], P = .008) were associated with red blood cell transfusion. In addition, patients with a preoperative hemoglobin ≥ 140 g/L (OR 0.157 [95% CI: 0.046-0.540], P = .003), and hemoglobin between 130 and 140 g/L (OR 0.195 [95% CI: 0.057-0.669], P = .009) were less likely to be transfused compared with patients with preoperative hemoglobin between 120 and 130 g/L (OR 0.294 [95% CI: 0.780-1.082], P = .066) or120 g/L (reference).Our study suggests that higher preoperative hemoglobin levels (130 g/L) are associated with a reduced need for red blood cell transfusion in pediatric patients who have received iron supplementation before undergoing posterior spinal fusion in our institution. The effect of iron supplementation, the optimal dosing, and duration of supplemental iron therapy remains unclear at this time.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6f39b51703dd36db778e2580a4ba61ec https://doi.org/10.1111/pan.13987 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.