Abstract
Background: In times of blood shortage, the department of health plan to cancel elective surgery requiring more than 2 units of blood cross matching preoperatively. We assessed the use of blood products in scoliosis surgery and identified factors increasing the need for post operative blood transfusion.
Methods: Prospective data collection. Forty four patients underwent corrective spinal surgery between January 2003 and June 2004. Numbers of units of blood cross matched pre operatively and transfused post operatively were calculated. Subtype of scoliosis and surgical approach were also identified.
Results: All patients were cross matched 6 units of blood pre operatively, total of 264 units. Only 133 units were actually transfused, giving an overall 50.4 % product use rate. All syndromic patients were transfused blood irrespective of surgical approach. Idiopathic patients who had a one stage anterior approach did not require transfusion. Idiopathic patients were transfused a mean of 2.4 units and 2.9 units for one stage posterior and 2 stage approaches respectively. Syndromic patients were transfused a mean of 2.5 units, 5.8 units and 4.2 units for one stage anterior, one stage posterior and 2 stage procedures respectively.
Conclusion: The department of health published a paper on contingency planning for the shortage of blood products (1). In times of shortage, those surgeries requiring preoperative cross matching of more than 2 units will be cancelled first. Therefore, not only is it important to reduce the waste of blood products from a cost perspective, but also to cross match appropriately to avoid unnecessary cancellation if blood shortages occur. Surgical approach and underlying diagnosis need to be identified when cross matching patients for corrective scoliosis surgery. Idiopathic scoliosis patients only require 2 units of blood cross matching preoperatively. Patients with syndromes require 2–6 units depending on the surgical approach. A prospective validation trial has been implemented to validate our retrospective findings.
The abstracts were prepared by Mr Colin E. Bruce. Correspondence should be addressed to Colin E. Bruce, Consultant Orthopaedic Surgeon, Alder Hey Children’s Hospital, Eaton Road, Liverpool, L12 2AP.
References:
1 Penny S, Gleave R, Frith L, et al. Emergency planning – Development of an integrated plan for the management of blood shortages. Department of Health, July 2004. Google Scholar
