scholarly journals Blood Transfusion and Postoperative Infection in Spine Surgery: A Systematic Review

2018 ◽  
Vol 8 (2) ◽  
pp. 198-207 ◽  
Author(s):  
Christian Fisahn ◽  
Cameron Schmidt ◽  
Josh E. Schroeder ◽  
Emiliano Vialle ◽  
Isador H. Lieberman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Transfusion ◽  
Tract Infection ◽  
Spine Surgery ◽  
Postoperative Infection ◽  
Allogeneic Blood Transfusion ◽  
Allogeneic Blood ◽  
Cochrane Central Register ◽  
Risk Of Infection ◽  
Allogeneic Transfusion

Study Design: Systematic review. Objectives: Allogeneic blood transfusion-related immunomodulation may relatively suppress the immune system, heightening the risk of infection following spine surgery. This systematic review seeks to determine whether allogeneic blood transfusion increases the risk of postoperative infection and whether there are any factors that modify this association. Methods: PubMed, Cochrane Central Register of Controlled Trials, and reference lists from included studies were searched from inception to April 20, 2017 to identify studies examining the risk of infection following allogeneic blood transfusion in adult patients receiving surgery for degenerative spine disease. Results: Eleven retrospective cohort or case-control studies, involving 8428 transfusion patients and 43 242 nontransfusion patients, were identified as meeting the inclusion criteria. Regarding surgical site infection (SSI), the results were mixed with roughly half reporting a significant association. There was an association between allogeneic transfusion and urinary tract infection (UTI) and any infection, but not respiratory tract infection. There was no statistical modifying effect of lumbar versus thoracic surgery on the association of allogeneic transfusion and SSI, though subgroup analyses in 3 of 4 studies reported a statistical association between transfusion and postoperative infections, including SSI, UTI, and any infection within the lumbar spine. Conclusions: This systematic review failed to find a consistent association between allogeneic transfusion and postoperative infection in spine surgery patients. However, these studies were all retrospective with a high or moderately high risk of bias. To properly examine this association an observational prospective study of sufficient power, estimated as 2400 patients, is required.

Association Between Allogeneic Blood Transfusion and Postoperative Infection in Major Spine Surgery

2017 ◽  
Vol 30 (7) ◽  
pp. E988-E992 ◽  
Author(s):  
Christian Fisahn ◽  
Shiveindra Jeyamohan ◽  
Daniel C. Norvell ◽  
Richard S. Tubbs ◽  
Marc Moisi ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Spine Surgery ◽  
Postoperative Infection ◽  
Allogeneic Blood Transfusion ◽  
Allogeneic Blood

scholarly journals Preoperative Anemia Treatment With Intravenous Iron in Patients Undergoing Major Orthopedic Surgery: A Systematic Review

2020 ◽  
Vol 11 ◽  
pp. 215145932093509
Author(s):  
Aaron Smith ◽  
Tiffany Moon ◽  
Taylor Pak ◽  
Brian Park ◽  
Richard D. Urman
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Blood Transfusion ◽  
Orthopedic Surgery ◽  
Allogeneic Blood Transfusion ◽  
Allogeneic Blood ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
Major Orthopedic Surgery ◽  
Iv Iron

Introduction: Based upon the Third National Health and Nutrition Examination Survey data, iron deficiency anemia is the cause of at least 20% of cases of anemia in adults over the age of 65. This is especially relevant in patients undergoing major orthopedic surgery as substantial perioperative blood loss is possible, leading to a high rate of allogeneic blood transfusion in total hip replacements, total knee replacements, and hip fracture repairs. Significance: The results of this systematic review may be of interest to clinicians and hospital administrators evaluating the clinical efficacy and cost effectiveness of intravenous (IV) iron administration prior to major orthopedic surgery. Materials and Methods: The original studies considered for this review included patients who were over 18 years of age, undergoing major orthopedic surgery, and who received an IV iron treatment in the preoperative setting. A total of 1083 articles were identified and reviewed. After removing duplicates, 1031 publications were screened, and 105 full-text studies were assessed for eligibility. A total of 98 were excluded and 7 articles remained which met the criteria for this review. The primary outcome examined in the included studies was the allogeneic blood transfusion rate. The secondary areas of interest were changes in serum hemoglobin, morbidity and mortality, length of stay, and cost effectiveness. Results: This systematic review found little evidence that IV iron therapy is effective at reducing transfusion in patients undergoing major orthopedic surgery. Conclusions: We do not recommend preoperative IV iron therapy for all patients scheduled for major orthopedic surgery.

Decline in allogeneic blood transfusion usage in total hip arthroplasty patients: National Inpatient Sample 2009 to 2013

2017 ◽  
Vol 28 (4) ◽  
pp. 382-390 ◽  
Author(s):  
Chukwuweike U. Gwam ◽  
Jaydev B. Mistry ◽  
Jennifer I. Etcheson ◽  
Nicole E. George ◽  
Grayson Connors ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Hip Arthroplasty ◽  
Blood Transfusion ◽  
Hip Arthroplasty ◽  
Allogeneic Blood Transfusion ◽  
Allogeneic Blood ◽  
National Inpatient Sample ◽  
Allogeneic Transfusion ◽  
Total Hip ◽  
Primary Thas

Introduction: Although total hip arthroplasty (THA) is an effective treatment for end-stage arthritis, it is also associated with substantial blood loss that may require allogeneic blood transfusion. However, these transfusions may increase the risk of certain complications. The purpose of our study is to evaluate: (i) the incidence/trends of allogeneic blood transfusion; (ii) the associated risk factors and adverse events; and (iii) the discharge disposition, length of stay (LOS), and costs for these patients between 2009 and 2013. Methods: The National Inpatient Sample database was used to identify 1,542,366 primary THAs performed between 2009 and 2013. Patients were stratified based on demographics, economic data, hospital characteristics, comorbidities, and whether or not allogeneic transfusion was received. Logistic regression was performed to evaluate the risk factors for transfusion and postoperative complications. Results: From 2009 to 2013, allogeneic transfusions were used in 16.9% of primary THAs, with a declining annual incidence. Except for obesity, all comorbidities were associated with increased likelihood of receiving a transfusion. Allogeneic transfusion patients were more likely to experience surgical site infections or pulmonary complications (p<0.001 for all). These patients were more likely to be discharged to a short-term care facility (p<0.001). Additionally, they had a greater mean LOS (p<0.001) and higher median hospital costs and charges when compared to their non-transfused counterparts. Conclusions: While the observed decline in allogeneic transfusion usage is encouraging, further efforts should focus on preoperative patient optimisation. Given the projected increase in demand for primary THAs, orthopaedic surgeons must be familiar with safe and effective blood conservation protocols.

scholarly journals Increased Risk of Infection and Mortality in Women after Cardiac Surgery Related to Allogeneic Blood Transfusion

2007 ◽  
Vol 16 (10) ◽  
pp. 1412-1420 ◽  
Author(s):  
Mary A.M. Rogers ◽  
Neil Blumberg ◽  
Joanna M. Heal ◽  
George L. Hicks, Jr.
Keyword(s):  
Cardiac Surgery ◽  
Blood Transfusion ◽  
Allogeneic Blood Transfusion ◽  
Allogeneic Blood ◽  
Risk Of Infection ◽  
Increased Risk

The Effects of Allogeneic Blood Transfusion in Hepatic Resection

2020 ◽  
pp. 000313482095028
Author(s):  
Yoshihiro Inoue ◽  
Masatsugu Ishii ◽  
Kensuke Fujii ◽  
Kazuya Kitada ◽  
Toru Kuramoto ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Hepatic Resection ◽  
Liver Regeneration ◽  
Postoperative Complication ◽  
Surgical Outcomes ◽  
Allogeneic Blood Transfusion ◽  
Allogeneic Blood ◽  
Remnant Liver ◽  
Allogeneic Transfusion ◽  
Significant Difference

Background Hepatectomy has a high risk of perioperative bleeding due to the underlying disease. Here, we investigated the postoperative impact of allogeneic blood transfusion during hepatectomy. Methods The surgical outcomes in 385 patients who underwent hepatic resection for hepatocellular carcinoma were retrospectively reviewed. The association of allogeneic blood transfusion with surgical outcomes and remnant liver regeneration data was analyzed. Results Eighty-six patients (24.0%) received an allogeneic blood transfusion and 272 patients (76.0%) did not. After propensity score matching, the incidence rates of postoperative complication (Clavien-Dindo grade >IIIA), posthepatectomy liver failure, and massive ascites were significantly higher for the group that received a blood transfusion than for the group that did not receive blood transfusion ( P < .001, P = .001, and <.001, respectively). Postoperative measures of total bilirubin, albumin, platelet count, prothrombin time, aspartate aminotransferase, and alanine aminotransferase were significantly more favorable in patients without blood transfusion until day 7 after surgery. There were no correlations in the remnant liver regeneration at 7 days, and 1, 2, 5, and 12 months postoperatively between the 2 groups ( P = .585, .383, .507, .261, and .430, respectively). Regarding prognosis, there was no significant difference in overall and recurrence-free survival between the 2 groups ( P = .065 and .166, respectively). Conclusion Allogeneic transfusion during hepatectomy strongly affected remnant liver function in the early postoperative period; however, this was not related to the remnant liver regeneration volume. Despite that the allogeneic transfusion resulted in poorer postoperative laboratory test results and increased postoperative complication and mortality rates, it had no effect on the long-term prognosis.

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