1.Risk factors for allogeneic red blood cell transfusion in adult spinal deformity surgery
Yasushi IIJIMA ; Toshiaki KOTANI ; Tsuyoshi SAKUMA ; Tsutomu AKAZAWA ; Shunji KISHIDA ; Keisuke UENO ; Shohei ISE ; Yosuke OGATA ; Masaya MIZUTANI ; Yasuhiro SHIGA ; Shohei MINAMI ; Seiji OHTORI
Asian Spine Journal 2024;18(4):579-586
Methods:
The medical records of 151 patients with ASD who underwent correction surgery between 2012 and 2021 were retrospectively reviewed. Estimated blood loss and perioperative allogeneic transfusion were examined. Patients were categorized into two groups based on whether they received perioperative allogeneic blood transfusion. Logistic regression analysis was employed to investigate the effect of age, sex, blood type, body mass index, American Society of Anesthesiologists’ physical status, preoperative hemoglobin level, autologous blood donation, global spine alignment parameters, preoperative use of anticoagulants or antiplatelet medicine and nonsteroidal anti-inflammatory drugs, number of instrumented fusion levels, total operative duration, three-column osteotomy, lateral interbody fusion, pelvic fixation, intraoperative hypothermia, use of gelatin-thrombin based hemostatic agents, and intraoperative tranexamic acid (TXA) with simultaneous exposure by two attending surgeons.
Results:
The estimated blood loss was 994.2±754.5 mL, and 71 patients (47.0%) received allogeneic blood transfusion. In the logistic regression analysis, the absence of intraoperative TXA use and simultaneous exposure (odds ratio [OR], 26.3; 95% confidence interval [CI], 7.6–90.9; p<0.001), lack of autologous blood donation (OR, 21.2; 95% CI, 4.4–100.0; p<0.001), and prolonged operative duration (OR, 1.6; 95% CI, 1.3–1.9; p<0.001) were significant independent factors for perioperative allogeneic blood transfusion in ASD surgery.
Conclusions
Autologous blood storage, intraoperative TXA administration, and simultaneous exposure should be considered to minimize perioperative allogeneic blood transfusion in ASD surgery, particularly in patients with anticipated lengthy surgeries.
2.Risk factors for allogeneic red blood cell transfusion in adult spinal deformity surgery
Yasushi IIJIMA ; Toshiaki KOTANI ; Tsuyoshi SAKUMA ; Tsutomu AKAZAWA ; Shunji KISHIDA ; Keisuke UENO ; Shohei ISE ; Yosuke OGATA ; Masaya MIZUTANI ; Yasuhiro SHIGA ; Shohei MINAMI ; Seiji OHTORI
Asian Spine Journal 2024;18(4):579-586
Methods:
The medical records of 151 patients with ASD who underwent correction surgery between 2012 and 2021 were retrospectively reviewed. Estimated blood loss and perioperative allogeneic transfusion were examined. Patients were categorized into two groups based on whether they received perioperative allogeneic blood transfusion. Logistic regression analysis was employed to investigate the effect of age, sex, blood type, body mass index, American Society of Anesthesiologists’ physical status, preoperative hemoglobin level, autologous blood donation, global spine alignment parameters, preoperative use of anticoagulants or antiplatelet medicine and nonsteroidal anti-inflammatory drugs, number of instrumented fusion levels, total operative duration, three-column osteotomy, lateral interbody fusion, pelvic fixation, intraoperative hypothermia, use of gelatin-thrombin based hemostatic agents, and intraoperative tranexamic acid (TXA) with simultaneous exposure by two attending surgeons.
Results:
The estimated blood loss was 994.2±754.5 mL, and 71 patients (47.0%) received allogeneic blood transfusion. In the logistic regression analysis, the absence of intraoperative TXA use and simultaneous exposure (odds ratio [OR], 26.3; 95% confidence interval [CI], 7.6–90.9; p<0.001), lack of autologous blood donation (OR, 21.2; 95% CI, 4.4–100.0; p<0.001), and prolonged operative duration (OR, 1.6; 95% CI, 1.3–1.9; p<0.001) were significant independent factors for perioperative allogeneic blood transfusion in ASD surgery.
Conclusions
Autologous blood storage, intraoperative TXA administration, and simultaneous exposure should be considered to minimize perioperative allogeneic blood transfusion in ASD surgery, particularly in patients with anticipated lengthy surgeries.
3.Risk factors for allogeneic red blood cell transfusion in adult spinal deformity surgery
Yasushi IIJIMA ; Toshiaki KOTANI ; Tsuyoshi SAKUMA ; Tsutomu AKAZAWA ; Shunji KISHIDA ; Keisuke UENO ; Shohei ISE ; Yosuke OGATA ; Masaya MIZUTANI ; Yasuhiro SHIGA ; Shohei MINAMI ; Seiji OHTORI
Asian Spine Journal 2024;18(4):579-586
Methods:
The medical records of 151 patients with ASD who underwent correction surgery between 2012 and 2021 were retrospectively reviewed. Estimated blood loss and perioperative allogeneic transfusion were examined. Patients were categorized into two groups based on whether they received perioperative allogeneic blood transfusion. Logistic regression analysis was employed to investigate the effect of age, sex, blood type, body mass index, American Society of Anesthesiologists’ physical status, preoperative hemoglobin level, autologous blood donation, global spine alignment parameters, preoperative use of anticoagulants or antiplatelet medicine and nonsteroidal anti-inflammatory drugs, number of instrumented fusion levels, total operative duration, three-column osteotomy, lateral interbody fusion, pelvic fixation, intraoperative hypothermia, use of gelatin-thrombin based hemostatic agents, and intraoperative tranexamic acid (TXA) with simultaneous exposure by two attending surgeons.
Results:
The estimated blood loss was 994.2±754.5 mL, and 71 patients (47.0%) received allogeneic blood transfusion. In the logistic regression analysis, the absence of intraoperative TXA use and simultaneous exposure (odds ratio [OR], 26.3; 95% confidence interval [CI], 7.6–90.9; p<0.001), lack of autologous blood donation (OR, 21.2; 95% CI, 4.4–100.0; p<0.001), and prolonged operative duration (OR, 1.6; 95% CI, 1.3–1.9; p<0.001) were significant independent factors for perioperative allogeneic blood transfusion in ASD surgery.
Conclusions
Autologous blood storage, intraoperative TXA administration, and simultaneous exposure should be considered to minimize perioperative allogeneic blood transfusion in ASD surgery, particularly in patients with anticipated lengthy surgeries.
4.Association between Osteoporosis and Skeletal Muscle Mass in Men
Masaya MIZUTANI ; Yawara EGUCHI ; Toru TOYOGUCHI ; Sumihisa ORITA ; Kazuhide INAGE ; Yasuhiro SHIGA ; Satoshi MAKI ; Junichi NAKAMURA ; Shigeo HAGIWARA ; Yasuchika AOKI ; Masahiro INOUE ; Masao KODA ; Hiroshi TAKAHASHI ; Tsutomu AKAZAWA ; Seiji OHTORI
Asian Spine Journal 2024;18(1):73-78
Methods:
This study included 99 men (mean age, 74.9 years; range, 28–93 years) who visited Qiball Clinic for BMD and body composition examinations. The osteoporosis group consisted of 24 patients (mean age, 72.5 years; range, 44–92 years), and the control group consisted of 75 individuals (mean age, 74.9 years; range, 28–93 years). Whole-body skeletal muscle mass was measured using a bioelectrical impedance analyzer. BMD was measured by dual X-ray absorptiometry. Skin autofluorescence (SAF), a marker of dermal AGE accumulation, was measured using a spectroscope. Osteoporosis was defined as a bone density T score of –2.5 or less. Physical findings, skeletal muscle mass, BMD, grip strength, and SAF were compared between the osteoporosis and control groups.
Results:
The osteoporosis group had significantly lower trunk muscle mass (23.1 kg vs. 24.9 kg), lower leg muscle mass (14.4 kg vs. 13.0 kg), and skeletal mass index (7.1 kg/m2 vs. 6.7 kg/m2) than the control group (all p<0.05). Lower limb muscle mass was identified as a risk factor for osteoporosis in men (odds ratio, 0.64; p=0.03).
Conclusions
Conservative treatment of osteoporosis in men will require an effective approach that facilitates the maintenance or strengthening of skeletal muscle mass, including exercise therapy with a focus on lower extremities and nutritional supplementation.
5.Risk factors for allogeneic red blood cell transfusion in adult spinal deformity surgery
Yasushi IIJIMA ; Toshiaki KOTANI ; Tsuyoshi SAKUMA ; Tsutomu AKAZAWA ; Shunji KISHIDA ; Keisuke UENO ; Shohei ISE ; Yosuke OGATA ; Masaya MIZUTANI ; Yasuhiro SHIGA ; Shohei MINAMI ; Seiji OHTORI
Asian Spine Journal 2024;18(4):579-586
Methods:
The medical records of 151 patients with ASD who underwent correction surgery between 2012 and 2021 were retrospectively reviewed. Estimated blood loss and perioperative allogeneic transfusion were examined. Patients were categorized into two groups based on whether they received perioperative allogeneic blood transfusion. Logistic regression analysis was employed to investigate the effect of age, sex, blood type, body mass index, American Society of Anesthesiologists’ physical status, preoperative hemoglobin level, autologous blood donation, global spine alignment parameters, preoperative use of anticoagulants or antiplatelet medicine and nonsteroidal anti-inflammatory drugs, number of instrumented fusion levels, total operative duration, three-column osteotomy, lateral interbody fusion, pelvic fixation, intraoperative hypothermia, use of gelatin-thrombin based hemostatic agents, and intraoperative tranexamic acid (TXA) with simultaneous exposure by two attending surgeons.
Results:
The estimated blood loss was 994.2±754.5 mL, and 71 patients (47.0%) received allogeneic blood transfusion. In the logistic regression analysis, the absence of intraoperative TXA use and simultaneous exposure (odds ratio [OR], 26.3; 95% confidence interval [CI], 7.6–90.9; p<0.001), lack of autologous blood donation (OR, 21.2; 95% CI, 4.4–100.0; p<0.001), and prolonged operative duration (OR, 1.6; 95% CI, 1.3–1.9; p<0.001) were significant independent factors for perioperative allogeneic blood transfusion in ASD surgery.
Conclusions
Autologous blood storage, intraoperative TXA administration, and simultaneous exposure should be considered to minimize perioperative allogeneic blood transfusion in ASD surgery, particularly in patients with anticipated lengthy surgeries.