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我们如何定义手术前贫血? 在接受短构造腰椎脊柱融合的患者中,对各种贫血值进行了比较

Tariq Z Issa¹, Omar H Tarawneh², Teeto Ezeonu²

¹Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai Hospital, New York, NY.

Journal of craniovertebral junction & spine

|August 4, 2025

概括

不同的贫血定义可靠地识别了脊髓融合后需要输血的患者. 世界卫生组织 (WHO) 的定义最能预测术后并发症,指导术前优化策略.

科学领域:

脊柱外科手术脊柱外科手术
麻醉学麻醉学
血液学血液学血液学

背景情况:

贫血是手术患者输血需求增加的已知危险因素.
目前的科学文献缺乏关于贫血诊断和手术前优化的共识.
存在各种贫血定义,需要对临床相关性进行比较.

研究的目的:

在预测输血需求和手术结果时,比较多种贫血定义.
评估最佳的贫血值,以识别需要在脊髓融合之前进行手术前优化治疗的患者.

主要方法:

对2257名经历1-2级后脊柱融合的患者进行了回顾性队列研究.
使用世界卫生组织 (WHO),美国血液学会 (ASH) 和克利夫兰诊所 (CC) 门诊断的贫血.
统计分析包括Youden指数和多变量回归来评估与结果的关联.

主要成果:

所有贫血定义都与输血率增加和非家庭出院有关.
世卫组织的贫血定义显示了输血的最高几率 (OR:7.48) 和与并发症相关 (OR:1.55).
贫血值可接受用于预测输血 (AUC>0.70),但预测并发症,再入院或非家庭出院的情况不佳.

结论:

贫血定义的微小变化不会显著改变需要输血的患者的识别.
世卫组织的贫血定义在预测腰部融合后的术后并发症方面似乎最有效.
标准化贫血评估可以改善患者选择进行手术前优化.

关键词:

贫血贫血是一种疾病.这是一个复杂的并发症.腰部脊柱腰部脊柱腰部脊柱脊柱融合是指脊柱的融合.输血是输血的方法之一.

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