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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 experie...

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Autores principales: Chocron, Yehuda, Azzi, Alain J., Galli, Rafael, Alnaif, Nayif, Atkinson, Jeffrey, Dudley, Roy, Farmer, Jean-Pierre, Gilardino, Mirko S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7015599/
https://www.ncbi.nlm.nih.gov/pubmed/32095402
http://dx.doi.org/10.1097/GOX.0000000000002592
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author Chocron, Yehuda
Azzi, Alain J.
Galli, Rafael
Alnaif, Nayif
Atkinson, Jeffrey
Dudley, Roy
Farmer, Jean-Pierre
Gilardino, Mirko S.
author_facet Chocron, Yehuda
Azzi, Alain J.
Galli, Rafael
Alnaif, Nayif
Atkinson, Jeffrey
Dudley, Roy
Farmer, Jean-Pierre
Gilardino, Mirko S.
author_sort Chocron, Yehuda
collection PubMed
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.
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spelling pubmed-70155992020-02-24 Operative Time as the Predominant Risk Factor for Transfusion Requirements in Nonsyndromic Craniosynostosis Repair Chocron, Yehuda Azzi, Alain J. Galli, Rafael Alnaif, Nayif Atkinson, Jeffrey Dudley, Roy Farmer, Jean-Pierre Gilardino, Mirko S. Plast Reconstr Surg Glob Open Original Article 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. Wolters Kluwer Health 2020-01-17 /pmc/articles/PMC7015599/ /pubmed/32095402 http://dx.doi.org/10.1097/GOX.0000000000002592 Text en Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Original Article
Chocron, Yehuda
Azzi, Alain J.
Galli, Rafael
Alnaif, Nayif
Atkinson, Jeffrey
Dudley, Roy
Farmer, Jean-Pierre
Gilardino, Mirko S.
Operative Time as the Predominant Risk Factor for Transfusion Requirements in Nonsyndromic Craniosynostosis Repair
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
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7015599/
https://www.ncbi.nlm.nih.gov/pubmed/32095402
http://dx.doi.org/10.1097/GOX.0000000000002592
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