A novel predictive model of perioperative blood transfusion requirement in tuberculous spondylitis patients undergoing posterior decompression and instrumentation.

التفاصيل البيبلوغرافية
العنوان:	A novel predictive model of perioperative blood transfusion requirement in tuberculous spondylitis patients undergoing posterior decompression and instrumentation.
المؤلفون:	Tobing SDAL; Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia., Kurniawan D; Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia. dodydocz@gmail.com., Canintika AF; Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia., Defian F; Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia., Zufar MLL; Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
المصدر:	International orthopaedics [Int Orthop] 2023 Jun; Vol. 47 (6), pp. 1545-1555. Date of Electronic Publication: 2023 Mar 27.
نوع المنشور:	Review; Journal Article
اللغة:	English
بيانات الدورية:	Publisher: Springer Verlag Country of Publication: Germany NLM ID: 7705431 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-5195 (Electronic) Linking ISSN: 03412695 NLM ISO Abbreviation: Int Orthop Subsets: MEDLINE
أسماء مطبوعة:	Original Publication: Berlin : Springer Verlag
مواضيع طبية MeSH:	Tuberculosis, Spinal/surgery , Spondylitis/surgery , Spinal Fusion*/methods, Humans ; Retrospective Studies ; Blood Transfusion ; Decompression
مستخلص:	Study Design: Retrospective study. Purpose: The aim of this study was to develop a predictive model for determining perioperative blood transfusion in tuberculous spondylitis patients undergoing posterior decompression and instrumentation. Background: Tuberculous spondylitis is a common infection found in the spine. This condition may result in the need of surgical treatment, especially when there is a delay in diagnosis with inadequate antituberculosis drug treatment. The procedure results in high amount of bleeding on many occasions, leading to the higher rate of intraoperative transfusion. We develop a predictive model that can be used to determine blood transfusion requirement in spinal tuberculosis surgery. Methods: We reviewed the medical records of 83 tuberculous spondylitis patients who underwent posterior decompression and instrumentation. The clinical characteristics of the patients were analyzed using bivariate and multivariate regression test. The impact and strength of these variables was assessed to predict the probability of intraoperative red blood cell transfusion presence based on unstandardized beta, standard error, receiver operating characteristic, and confluence of sensitivity and specificity curve analyses. Furthermore, validation of this newly proposed predictive scoring system was performed using a set of 45 patients. Results: The factors that significantly affect the need of blood transfusion during posterior spondylitis tuberculosis surgery were BMI (p = 0.005), pre-operative Hb (p < 0.001), number of affected segments (p = 0.042), and duration of surgery (p = 0.003). Our predictive model showed good sensitivity and specificity values based on a large area under the curve (0.913) and strong Pearson's r testing (correlation coefficient of 0.752). Validation set also resulted a large area under the curve (0.905) and strong correlation coefficient of 0.713. Conclusion: BMI, pre-operative Hb, number of affected segments, and duration of surgery became the significant factors which correlated to the presence of red blood cell transfusion in patients undergoing posterior spondylitis tuberculosis surgery. This predictive scoring system can be used to further adjust blood matching and inventory, determine intraoperative blood management, and ensure the safety of surgery in a comprehensive manner. (© 2023. The Author(s) under exclusive licence to SICOT aisbl.)
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فهرسة مساهمة:	Keywords: Perioperative blood transfusion requirement; Posterior decompression and instrumentation; Predictive scoring system; Tuberculous spondylitis
تواريخ الأحداث:	Date Created: 20230327 Date Completed: 20230522 Latest Revision: 20230711
رمز التحديث:	20231215
DOI:	10.1007/s00264-023-05744-7
PMID:	36971817
قاعدة البيانات:	MEDLINE

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تدمد:	1432-5195
DOI:	10.1007/s00264-023-05744-7