White et al identified risk factors for perioperative blood transfusion associated with adult spinal deformity surgery. These can help to identify a patient who may require more aggressive blood conservation methods or an alternative operation. The authors are from Icahn School of Medicine at Mount Sinai.
Patient-specific risk factors:
(1) age >= 65 years (OR 1.7)
(2) ASA class >= 3 (OR 1.2)
(3) cardiac comorbidity (OR 1.2)
(4) bleeding disorder (OR 2)
Surgery specific risk factors:
(1) posterior approach (OR 4.3) or combined (OR 3.6) versus anterior approach
(2) pelvic fixation (OR 1.7)
(3) osteotomy (OR 2.1)
(4) duration of surgery in hours (2nd quartile OR 1.9; 3rd quartile 3.6; 4th quartile 12.3)
Factors associated with reduced risk:
(1) male sex (OR 0.7)
(2) independent functional status (OR 0.7)
(3) short fusion length (OR 0.7)
