Abstract
Introduction: This study aimed to evaluate the use of a cell savage and its impact on the amount of allogenic blood transfused to the patients during idiopathic scoliosis surgery. Methods: A total of 142 randomly selected patients with scoliosis had been included in this study. The adult group consisted of 78 patients, and the pediatric group, 64 patients. Both groups were divided into subgroups (pre-cell saver era and cell saver era). Data on the following parameters were collected: amount of blood transfused intraoperatively, within 24 h postoperatively, and overall. The number of patients who received transfusion was counted as the number of patients who avoided any transfusion. For statistical purposes, we performed unpaired student t-test, chi-square test, and Mann–Whitney test. Results: There was no significant difference in adult groups perioperatively. In the pediatric group, there was a statistically significant difference intraoperatively. Economic analysis of blood management showed positive numbers for both groups, where more than 1 unit of blood was transfused. Conclusions: Statistical analysis showed the cost-effectiveness of the perioperative use of cell salvage during pediatric scoliosis surgery. Overall, the use of cell salvage during scoliosis surgery had a positive impact on both blood management and patient recovery.
Highlights
Blood transfusion, while recognized as an essential therapy when needed, is not without risk [1]
Similar data showed that postoperative infection was reduced when allogenic transfusions were avoided in patients undergoing primary arthroplasty [8]
Al-Mohrej et al found that surgical interventions for patients with idiopathic scoliosis were generally correlated with intraoperative bleeding that necessitated transfusion, which in turn increased the risk of infection and wound complications [9]
Summary
While recognized as an essential therapy when needed, is not without risk [1]. Relevant to orthopedics and spine surgery is the evidence that transfusions can increase the risk of morbidity and mortality [3,4,5,6]. Al-Mohrej et al found that surgical interventions for patients with idiopathic scoliosis were generally correlated with intraoperative bleeding that necessitated transfusion, which in turn increased the risk of infection and wound complications [9]. It costs the hospital in terms of length of stay, pain relief, antibiotic cover, and possibly prolonged home care [10]
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