Effects of Patient-, Clinician- and Institutional-level Variation in
Blood Product Transfusion Practices during Major Spine Surgery:
A Multicenter Observational Study
Brian Reon MD, PhD
Assistant Professor
University of Virginia
Outline
Background
Background
Carson, J.L., et al. Red Blood Cell Transfusion: 2023 AABB International Guidelines. JAMA (2023) doi:10.1001/jama.2023.12914
Aims
Study Design
Results
Total Cases
Results
Rates of Any Blood Product Transfusion Rates of Blood Product Transfusion by Type
Results
Ongoing Work
• Better characterizing the variation of blood product transfusion practices in
complex spine surgeries
• Using generalized linear mixed effect regression (GLMER) models, to
examine the relative contributions of patient-, provider-, surgical case type-,
and institution-level factors on blood product administration.
Conclusions
• Although the rate of blood product transfusion has decreased from 2018 – 2023, patients receive
blood products while undergoing Non-emergent complex spine surgery
• Intraoperative transfusion of blood products in adults undergoing non-emergent complex spine
surgery are associated with:
– Age, Female and high-volume anesthesiologists
– Surgical approach and number of spine levels
– Intraoperative blood loss and preoperative anemia
• Better understanding of the factors associated with intraoperative transfusions can help risk stratify
patients preoperatively
Lessons Learned
Thank You
References
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