Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jul 2014
Observational StudyDevelopment and Validation of a Generalizable Model for Predicting Major Transfusion During Spine Fusion Surgery.
Surgery for posterior spine instrumentation often requires major transfusion. The aim of this study was to develop and test the validity of a model for predicting intraoperative major transfusion (>4 U total red blood cells), based on preoperative patient and surgical variables, that was applicable to adult patients undergoing cervical, thoracic, and/or lumbar spine deformity surgery with and without osteotomies. ⋯ Our model has an increased accuracy for predicting the probability of major transfusion compared with a previously published model. In addition, our model is applicable to all types of spine fusion surgery and accounts for the complexity of surgical instrumentation, the number of levels instrumented, and the predicted duration of surgery as independent variables.
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J Neurosurg Anesthesiol · Jul 2014
Infratentorial Neurosurgery Is an Independent Risk Factor for Respiratory Failure and Death in Patients Undergoing Intracranial Tumor Resection.
Respiratory failure and death are devastating outcomes in the postoperative period. Patients undergoing neurosurgical procedures experience a greater frequency of respiratory failure compared with other surgical specialties. Resection of infratentorial mass lesions may be associated with an even higher risk because of several unique factors. Our objectives were: (1) to determine the incidence of postoperative respiratory failure and death in the neurosurgical population; and (2) to determine whether infratentorial procedures are associated with a higher risk compared with supratentorial procedures. ⋯ Infratentorial neurosurgery is an independent risk factor for respiratory failure and death in patients undergoing intracranial tumor resection. Mortality is an important contributor to this risk and should be a focus for future research.