Journal of neurosurgery. Spine
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OBJECTIVE The aim of this study was to characterize the association between percentage change in hemoglobin (ΔHb)-i.e., the difference between preoperative Hb and in-hospital nadir Hb concentration-and perioperative adverse events among spine surgery patients. METHODS Patients who underwent spine surgery at the authors' institution between December 4, 2008, and June 26, 2015, were eligible for this retrospective study. Patients who underwent the following procedures were included: atlantoaxial fusion, subaxial anterior cervical fusion, subaxial posterior cervical fusion, anterior lumbar fusion, posterior lumbar fusion, lateral lumbar fusion, excision of intervertebral disc, and excision of spinal cord lesion. ⋯ Hospital-related infection, which occurred in 60 patients (1.5%), was also more common in patients with greater percentage ΔHb (p = 0.001). CONCLUSIONS Percentage ΔHb is independently associated with a higher risk of developing any perioperative complication and hospital-related infection. The authors' results suggest that percentage ΔHb may be a useful measure for identifying patients at risk for adverse perioperative events.