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Pre-Operative Autologous Blood Donation Does Not Affect Pre-Incision Hematocrit in Adolescent Idiopathic Scoliosis Patients. A Retrospective Cohort of a Prospective Randomized Trial
Journal article   Open access   Peer reviewed

Pre-Operative Autologous Blood Donation Does Not Affect Pre-Incision Hematocrit in Adolescent Idiopathic Scoliosis Patients. A Retrospective Cohort of a Prospective Randomized Trial

Anthony J. Boniello, Kushagra Verma, Austin Peters, Baron S. Lonner and Thomas Errico
International journal of spine surgery, v 10(2016), pp 27-27
01 Jan 2016
PMID: 27652198
url
http://www.ijssurgery.com/content/ijss/10/27.full.pdfView
Published, Version of Record (VoR) Open
url
https://doi.org/10.14444/3027View
Published, Version of Record (VoR) Open

Abstract

Life Sciences & Biomedicine Science & Technology Surgery
Background Pre-donation of autologous blood prior to spine fusion for adolescent idiopathic scoliosis (AIS)has been used in deformity surgery. The effect of pre-donation on pre-operative hematocrit (Hct) remains debated. Multiple factors may influence pre-operative Hct including intravascular volume status, patient factors, and timing of pre-operative blood donation. The purpose of this study was to determine if pre-donation significantly lowers pre-incision Hct in AIS patients. Methods A retrospective cohort study of a Level-1 prospective randomized trial was conducted. 125 patients from the homogeneous population were included. AIS patients undergoing a posterior only spinal fusion for AIS were separated into two groups based on their pre-operative blood donation history. Demographic variables, pre-incision Hct, and transfusion rates were compared between the two groups using the Student's T-test. Results Pre-donation and non pre-donation groups had 28 and 97 patients, respectively. Pre-donation group was 75% female (21F, 7M) and non pre-donation group was 78% female (76F, 21M). There was no difference between predonation and non pre-donation groups in mean age (15.6 +/- 2.2 vs 14.8 +/- 2.2, p= 0.081), BMI (23.1 +/- 4.2 vs 21.7 +/- 5.3, p= 0.219), and pre-incision Hct (32.8 +/- 3.4 vs 33.8 +/- 3.1, p= 0.628). The overall transfusion rates were equivalent (32.1 +/- 48.0% vs 25.8 +/- 44.0%, p= 0.509), however, the rate of allogenic transfusion for the pre- donation group was significantly lower (3.6 +/- 18.9% vs 25.8 +/- 44.0%, p= 0.011). Conclusions This study supports the use of pre- donation for AIS, without a significant drop in pre- incision Hct. Patients that donate are also much less likely to be exposed to allogenic blood. There may be a surgeon bias to recommend predonation in patients with a larger BMI and older age. Future studies are needed from a larger population of patients including those with non-AIS pathology. Level of evidence: Level III.

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Collaboration types
Domestic collaboration
Web of Science research areas
Surgery
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