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Establishment and assessment of a nomogram for predicting blood transfusion risk in posterior lumbar spinal fusion

BACKGROUND: The aim of this study was to determine the risk factors and develop a nomogram for blood transfusions after posterior lumbar spinal fusion (PSL). METHODS: We conducted a retrospective, single-center study based on 885 patients receiving PSL, and data was obtained from May 2015 to Septemb...

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Autores principales: Wang, Haosheng, Wang, Kai, Lv, Bin, Xu, Haotian, Jiang, Weibo, Zhao, Jianwu, Kang, Mingyang, Dong, Rongpeng, Qu, Yang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7798229/
https://www.ncbi.nlm.nih.gov/pubmed/33430895
http://dx.doi.org/10.1186/s13018-020-02053-2
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author Wang, Haosheng
Wang, Kai
Lv, Bin
Xu, Haotian
Jiang, Weibo
Zhao, Jianwu
Kang, Mingyang
Dong, Rongpeng
Qu, Yang
author_facet Wang, Haosheng
Wang, Kai
Lv, Bin
Xu, Haotian
Jiang, Weibo
Zhao, Jianwu
Kang, Mingyang
Dong, Rongpeng
Qu, Yang
author_sort Wang, Haosheng
collection PubMed
description BACKGROUND: The aim of this study was to determine the risk factors and develop a nomogram for blood transfusions after posterior lumbar spinal fusion (PSL). METHODS: We conducted a retrospective, single-center study based on 885 patients receiving PSL, and data was obtained from May 2015 to September 2019. Univariable and multivariable logistics regression analysis were conducted to identify risk factors for blood transfusion, and a nomogram was constructed to individually evaluate the risk of blood transfusion. Discrimination, calibration, and clinical usefulness were validated by the receiver operating characteristics (ROC), C-index, calibration plot, and decision curve analysis, respectively. Bootstrapping validation was performed to assess the performance of the model. RESULTS: Of 885 patients, 885 were enrolled in the final study population, and 289 received blood transfusion. Statistical analyses showed that low preoperative hemoglobin (Hb), longer time to surgery, operative time, levels of fusion > 1, longer surgery duration, and higher total intraoperative blood loss (IBL) were the risk factors for transfusion. The C-index was 0.898 (95% CI 0.847–0.949) in this dataset and 0.895 in bootstrapping validation, respectively. Calibration curve showed satisfied discrimination and calibration of the nomogram. Decision curve analysis (DCA) shown that the nomogram was clinical utility. CONCLUSIONS: In summary, we investigated the relationship between the blood transfusion requirement and predictors: levels of fusion, operative time, time to surgery, total intraoperative EBL, and preoperative Hb level. Our nomogram with a robust performance in the assessment of risk of transfusion can contribute to clinicians in making clinical decision. However, external validation is still needed in the further. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13018-020-02053-2.
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spelling pubmed-77982292021-01-11 Establishment and assessment of a nomogram for predicting blood transfusion risk in posterior lumbar spinal fusion Wang, Haosheng Wang, Kai Lv, Bin Xu, Haotian Jiang, Weibo Zhao, Jianwu Kang, Mingyang Dong, Rongpeng Qu, Yang J Orthop Surg Res Research Article BACKGROUND: The aim of this study was to determine the risk factors and develop a nomogram for blood transfusions after posterior lumbar spinal fusion (PSL). METHODS: We conducted a retrospective, single-center study based on 885 patients receiving PSL, and data was obtained from May 2015 to September 2019. Univariable and multivariable logistics regression analysis were conducted to identify risk factors for blood transfusion, and a nomogram was constructed to individually evaluate the risk of blood transfusion. Discrimination, calibration, and clinical usefulness were validated by the receiver operating characteristics (ROC), C-index, calibration plot, and decision curve analysis, respectively. Bootstrapping validation was performed to assess the performance of the model. RESULTS: Of 885 patients, 885 were enrolled in the final study population, and 289 received blood transfusion. Statistical analyses showed that low preoperative hemoglobin (Hb), longer time to surgery, operative time, levels of fusion > 1, longer surgery duration, and higher total intraoperative blood loss (IBL) were the risk factors for transfusion. The C-index was 0.898 (95% CI 0.847–0.949) in this dataset and 0.895 in bootstrapping validation, respectively. Calibration curve showed satisfied discrimination and calibration of the nomogram. Decision curve analysis (DCA) shown that the nomogram was clinical utility. CONCLUSIONS: In summary, we investigated the relationship between the blood transfusion requirement and predictors: levels of fusion, operative time, time to surgery, total intraoperative EBL, and preoperative Hb level. Our nomogram with a robust performance in the assessment of risk of transfusion can contribute to clinicians in making clinical decision. However, external validation is still needed in the further. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13018-020-02053-2. BioMed Central 2021-01-11 /pmc/articles/PMC7798229/ /pubmed/33430895 http://dx.doi.org/10.1186/s13018-020-02053-2 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Wang, Haosheng
Wang, Kai
Lv, Bin
Xu, Haotian
Jiang, Weibo
Zhao, Jianwu
Kang, Mingyang
Dong, Rongpeng
Qu, Yang
Establishment and assessment of a nomogram for predicting blood transfusion risk in posterior lumbar spinal fusion
title Establishment and assessment of a nomogram for predicting blood transfusion risk in posterior lumbar spinal fusion
title_full Establishment and assessment of a nomogram for predicting blood transfusion risk in posterior lumbar spinal fusion
title_fullStr Establishment and assessment of a nomogram for predicting blood transfusion risk in posterior lumbar spinal fusion
title_full_unstemmed Establishment and assessment of a nomogram for predicting blood transfusion risk in posterior lumbar spinal fusion
title_short Establishment and assessment of a nomogram for predicting blood transfusion risk in posterior lumbar spinal fusion
title_sort establishment and assessment of a nomogram for predicting blood transfusion risk in posterior lumbar spinal fusion
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7798229/
https://www.ncbi.nlm.nih.gov/pubmed/33430895
http://dx.doi.org/10.1186/s13018-020-02053-2
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