Do Antifibrinolytic Agents Reduce the Risk of Blood Transfusion in Children Undergoing Spinal Fusion?: A Propensity Score-matched Comparison Using a National Database.

Spine
Lisa D EislerMinjae Kim

Abstract

Retrospective cohort. To evaluate the effectiveness and safety of antifibrinolytic (AF) agents in reducing perioperative blood transfusion in pediatric patients undergoing spinal fusion. The potential for AF to decrease bleeding and reduce exposure to allogenic transfusions has led to widespread off-label use in a number of major pediatric surgical procedures. Recent reviews call for improving the body of evidence for their effectiveness and safety in pediatric spinal fusion. Children undergoing spinal fusion were identified in the American College of Surgeons National Surgical Quality Improvement Program Pediatric (NSQIP-P) 2016 and 2017 databases. Univariate analyses of patient and perioperative characteristics informed the creation of a propensity score model predicting treatment with AF, followed by 1:1 matching to allow comparison of allogenic red blood cell transfusion rates and secondary outcomes between treated and untreated patients. Of 6626 total patients, 5434 (81%) received AF and 1533 (23%) received a blood transfusion. Analysis of data for 1192 propensity score-matched pairs revealed that treatment with AF was associated with a statistically nonsignificant 16% reduction in perioperative transfusion (OR 0.84, 95% c...Continue Reading

References

Jun 29, 2001·Anesthesia and Analgesia·D T NeilipovitzW M Splinter
Nov 5, 2003·Spine·Jennifer W ColeLawrence G Lenke
Sep 30, 2008·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Stepan KasimianVernon T Tolo
Feb 4, 2009·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Esther S SchoutenCasper W Bollen
Mar 30, 2010·Journal of Thrombosis and Haemostasis : JTH·N RosencherC-M Samama
Apr 26, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·David FaraoniPhilippe Van der Linden
Oct 5, 2013·Journal of Spinal Disorders & Techniques·Lisa M McLeodRon Keren
May 31, 2014·The Journal of Bone and Joint Surgery. American Volume·Kushagra VermaBaron S Lonner
Jul 11, 2014·Spine·Amit JainPaul D Sponseller
Mar 12, 2016·Seizure : the Journal of the British Epilepsy Association·Zhang Lin, Zou Xiaoyi
Mar 28, 2016·The Journal of Emergency Medicine·Daniel K NishijimaNathan Kuppermann
May 21, 2016·Journal of Neurosurgery. Spine·Kavelin RumallaIan G Dorward
Feb 17, 2017·British Journal of Anaesthesia·S M Goobie
Feb 18, 2017·Paediatric Anaesthesia·Susan M GoobieUNKNOWN the Pediatric Craniofacial Collaborative Group
Jul 12, 2017·Anesthesiology·Susan M Goobie, Steven M Frank
Nov 10, 2017·Journal of Pediatric Orthopedics·Daniel J JohnsonSteven M Frank
Mar 14, 2019·Anaesthesia and Intensive Care·Thomas W PainterKate Leslie

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Citations

Sep 22, 2020·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·Hideyuki ArimaDaisuke Sakai

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