Northwestern Medicine scientists have developed a new model for predicting the probability of major blood transfusion during spine surgery.

The model applies to adults undergoing complex spine fusion surgery, which can result in significant blood loss and the need for blood transfusion. It uses variables that can be determined before surgery to foresee when major transfusion will be necessary.

A study, published in the Journal of Neurological Anesthesiology, used data from 548 patients to develop the model, and then tested its validity on 95 additional patients. The model is the first to focus on major transfusion, usually about 40 percent or more of a patient’s blood volume, during the intraoperative period. It works for all types of spine fusion surgery, including cervical, thoracic and lumbar spine deformity surgery.

“This allows the anesthesia team to prepare the patient both mentally and physically for the complexity of their surgery and anesthetic care plan,” said first author Louanne Carabini, M.D. “We found that the length of surgery as well as the complexity of the operation are both predictors of major blood loss. The patient's history of anemia adds to the risk of them requiring major transfusion. 

“These findings are important especially in the rising culture of cost effectiveness when all preoperative testing, preparedness, and intraoperative management must be justified with a risk benefit analysis.” 

The study is available here.

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