• Raúl Torres-Claramunt, Manuel Ramírez, Mercedes López-Soques, Guillem Saló, Antoni Molina-Ros, Andreu Lladó, and Enric Cáceres.
• Orthopaedic Departement Parc de Salut Mar, Universitat Autònoma Barcelona, Passeig Marítim 25-29, 08003 Barcelona, Spain. RTorresClaramunt@parcdesalutmar.cat
• Arch Orthop Trauma Surg. 2012 Oct 1;132(10):1393-8.

BackgroundThe requirement of blood in the surgery of degenerative conditions of lumbar spine is around 10 %. Preoperative autologous blood donation is an effective method that is used in surgeries with an important blood loss. This is an expensive method because of the great number of predonated blood units not used in the postoperative period (around 70 % in our practice).ObjectiveTo know the risk factors associated with transfusion in the postoperative period in patients who undergo surgeries of degenerative conditions of the lumbar spine.MethodsWe designed a retrospective study of 142 cases of patients operated for degenerative conditions of the lumbar spine (not including simple disk hernia or adult degenerative scoliosis).ResultsFemale sex, age >60 years, preoperative ASA score 3 and preoperative hemoglobin ≤136 g/L are the risk factors related to the need of blood transfusion in the postoperative period. After application of a statistical study, female sex and preoperative ASA score 3 were the most important variables to explain transfusional risk. A woman with ASA score 3 has a 61 % foretold probability to be transfused in the postoperative period, while a man with ASA < 3, only 1.1 %. For this reason, application of this method to patients with these risk factors is more cost-effective.ConclusionsFemales, ASA 3, preoperative hemoglobin ≤136 g/L and age older than 60 years increase the risk to be transfused in the postoperative period for degenerative conditions of the spine.

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