Hassan et al identified a number of risk factors for blood transfusion in a pediatric patient undergoing surgery to correct a spinal deformity. The authors are from the Grand Valley State University in Allendale, Michigan, and the Helen DeVos Children's Hospital in Grand Rapids.


Patient selection: pediatric patient undergoing spinal deformity surgery


Risk factors for blood transfusion:

(1) more extensive surgery (presumably requiring a longer operation)

(2) blood loss during and after surgery in mL per kilogram body weight

(3) von Willebrand's disease (with a low levels of von Willebrand Factor) or history of significant bleeding



• The mean blood loss as a percent of total blood volume in the nontransfused group was 30% vs 100% in the transfused group.


Factors associated with more extensive surgery:

(1) greater number of segments operated upon

(2) neuromuscular scoliosis (vs idiopathic)

(3) increased Cobb angle (greater than 80°)

Blood Loss in mL per kg

Percent Transfused

< 25


25 to 50


51 to 75


> 75



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