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[Translated article] Pre-transfusion testing in cervical spine surgery: Are we overprepared?
A Taberner1, J D Montenegro1, K Zelada2
1Unidad de Cirugía de Columna, Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Mutua Terrassa, Barcelona, Spain.
Summary
Routine pre-transfusion testing may be unnecessary for anterior cervical arthrodesis (ACA) patients with hemoglobin above 12 g/dL. This can help optimize preoperative protocols and reduce unnecessary blood work.
Area of Science:
- Orthopedic Surgery
- Transfusion Medicine
- Anesthesiology
Background:
- Routine pre-transfusion testing is often deemed unnecessary for cervical spine surgery patients with adequate hemoglobin (Hb).
- The necessity of this testing for anterior cervical arthrodesis (ACA) specifically requires further investigation.
Purpose of the Study:
- To evaluate the necessity of routine pre-transfusion testing in patients undergoing ACA.
- To determine if preoperative hemoglobin levels are predictive of transfusion needs in ACA patients.
Main Methods:
- A prospective study analyzed 318 patients undergoing ACA for degenerative conditions.
- Bivariate analyses identified predictive factors for transfusion, including preoperative Hb levels.
- Crossmatch-to-transfusion ratio (C/T), likelihood of transfusion (%T), and transfusion index (TI) were assessed.
Main Results:
- Only 2 (0.6%) of 318 patients required transfusion.
- Patients with Hb < 12 g/dL had significantly higher odds of transfusion (OR 25.33, p=0.02).
- Age, ASA score, and transfusion rate differed significantly between Hb groups (<12 g/dL vs. ≥12 g/dL).
Conclusions:
- Routine pre-transfusion testing and blood reservation can likely be limited for ACA patients.
- Eliminating routine testing, especially for patients with Hb ≥ 12 g/dL, can optimize preoperative protocols.
- These findings support streamlining transfusion management in ACA surgery.
