Operative Time as the Predominant Risk Factor for Transfusion Requirements in Nonsyndromic Craniosynostosis Repair
Background:. Despite recent advances in surgical, anesthetic, and safety protocols in the management of nonsyndromic craniosynostosis (NSC), significant rates of intraoperative blood loss continue to be reported by multiple centers. The purpose of the current study was to examine our center’s experi...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2020-01-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000002592 |
| _version_ | 1819009732194598912 |
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| author | Yehuda Chocron, MD Alain J. Azzi, MD Rafael Galli, MD Nayif Alnaif, MD Jeffrey Atkinson, MD, FRCSC Roy Dudley, MD, FRCSC Jean-Pierre Farmer, MD, FRCSC Mirko S. Gilardino, MD, FRCSC |
| author_facet | Yehuda Chocron, MD Alain J. Azzi, MD Rafael Galli, MD Nayif Alnaif, MD Jeffrey Atkinson, MD, FRCSC Roy Dudley, MD, FRCSC Jean-Pierre Farmer, MD, FRCSC Mirko S. Gilardino, MD, FRCSC |
| author_sort | Yehuda Chocron, MD |
| collection | DOAJ |
| description | Background:. Despite recent advances in surgical, anesthetic, and safety protocols in the management of nonsyndromic craniosynostosis (NSC), significant rates of intraoperative blood loss continue to be reported by multiple centers. The purpose of the current study was to examine our center’s experience with the surgical correction of NSC in an effort to determine independent risk factors of transfusion requirements.
Methods:. A retrospective cohort study of patients with NSC undergoing surgical correction at the Montreal Children’s Hospital was carried out. Baseline characteristics and perioperative complications were compared between patients receiving and not receiving transfusions and between those receiving a transfusion in excess or <25 cc/kg. Logistic regression analysis was carried out to determine independent predictors of transfusion requirements.
Results:. A total of 100 patients met our inclusion criteria with a mean transfusion requirement of 29.6 cc/kg. Eighty-seven patients (87%) required a transfusion, and 45 patients (45%) required a significant (>25 cc/kg) intraoperative transfusion. Regression analysis revealed that increasing length of surgery was the main determinant for intraoperative (P = 0.008; odds ratio, 18.48; 95% CI, 2.14–159.36) and significant (>25 cc/kg) intraoperative (P = 0.004; odds ratio, 1.95; 95% CI, 1.23–3.07) transfusions.
Conclusions:. Our findings suggest increasing operative time as the predominant risk factor for intraoperative transfusion requirements. We encourage craniofacial surgeons to consider techniques to streamline the delivery of their selected procedure, in an effort to reduce operative time while minimizing the need for transfusion. |
| first_indexed | 2024-12-21T01:01:02Z |
| format | Article |
| id | doaj.art-5bd29f89b6ef47b2baaa05d0cce875c3 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-12-21T01:01:02Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-5bd29f89b6ef47b2baaa05d0cce875c32022-12-21T19:21:10ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742020-01-0181e259210.1097/GOX.0000000000002592202001000-00007Operative Time as the Predominant Risk Factor for Transfusion Requirements in Nonsyndromic Craniosynostosis RepairYehuda Chocron, MD0Alain J. Azzi, MD1Rafael Galli, MD2Nayif Alnaif, MD3Jeffrey Atkinson, MD, FRCSC4Roy Dudley, MD, FRCSC5Jean-Pierre Farmer, MD, FRCSC6Mirko S. Gilardino, MD, FRCSC7From the * Division of Plastic and Reconstructive Surgery, McGill University, Montreal, Quebec, CanadaFrom the * Division of Plastic and Reconstructive Surgery, McGill University, Montreal, Quebec, CanadaFrom the * Division of Plastic and Reconstructive Surgery, McGill University, Montreal, Quebec, CanadaFrom the * Division of Plastic and Reconstructive Surgery, McGill University, Montreal, Quebec, Canada† Department of Neurosurgery, McGill University, Montreal, Quebec, Canada.† Department of Neurosurgery, McGill University, Montreal, Quebec, Canada.† Department of Neurosurgery, McGill University, Montreal, Quebec, Canada.From the * Division of Plastic and Reconstructive Surgery, McGill University, Montreal, Quebec, CanadaBackground:. Despite recent advances in surgical, anesthetic, and safety protocols in the management of nonsyndromic craniosynostosis (NSC), significant rates of intraoperative blood loss continue to be reported by multiple centers. The purpose of the current study was to examine our center’s experience with the surgical correction of NSC in an effort to determine independent risk factors of transfusion requirements. Methods:. A retrospective cohort study of patients with NSC undergoing surgical correction at the Montreal Children’s Hospital was carried out. Baseline characteristics and perioperative complications were compared between patients receiving and not receiving transfusions and between those receiving a transfusion in excess or <25 cc/kg. Logistic regression analysis was carried out to determine independent predictors of transfusion requirements. Results:. A total of 100 patients met our inclusion criteria with a mean transfusion requirement of 29.6 cc/kg. Eighty-seven patients (87%) required a transfusion, and 45 patients (45%) required a significant (>25 cc/kg) intraoperative transfusion. Regression analysis revealed that increasing length of surgery was the main determinant for intraoperative (P = 0.008; odds ratio, 18.48; 95% CI, 2.14–159.36) and significant (>25 cc/kg) intraoperative (P = 0.004; odds ratio, 1.95; 95% CI, 1.23–3.07) transfusions. Conclusions:. Our findings suggest increasing operative time as the predominant risk factor for intraoperative transfusion requirements. We encourage craniofacial surgeons to consider techniques to streamline the delivery of their selected procedure, in an effort to reduce operative time while minimizing the need for transfusion.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000002592 |
| spellingShingle | Yehuda Chocron, MD Alain J. Azzi, MD Rafael Galli, MD Nayif Alnaif, MD Jeffrey Atkinson, MD, FRCSC Roy Dudley, MD, FRCSC Jean-Pierre Farmer, MD, FRCSC Mirko S. Gilardino, MD, FRCSC Operative Time as the Predominant Risk Factor for Transfusion Requirements in Nonsyndromic Craniosynostosis Repair Plastic and Reconstructive Surgery, Global Open |
| title | Operative Time as the Predominant Risk Factor for Transfusion Requirements in Nonsyndromic Craniosynostosis Repair |
| title_full | Operative Time as the Predominant Risk Factor for Transfusion Requirements in Nonsyndromic Craniosynostosis Repair |
| title_fullStr | Operative Time as the Predominant Risk Factor for Transfusion Requirements in Nonsyndromic Craniosynostosis Repair |
| title_full_unstemmed | Operative Time as the Predominant Risk Factor for Transfusion Requirements in Nonsyndromic Craniosynostosis Repair |
| title_short | Operative Time as the Predominant Risk Factor for Transfusion Requirements in Nonsyndromic Craniosynostosis Repair |
| title_sort | operative time as the predominant risk factor for transfusion requirements in nonsyndromic craniosynostosis repair |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000002592 |
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