(P-PB-8) Blood transfusion and clinical outcomes in spinal surgery: a meta-analysis and systematic review of 185,557 individuals

Background/Case Studies: We conducted a meta-analysis to comprehensively summarize and assess the credibility of the evidence concerning transfusion role in postoperative clinical outcomes in spine surgery.

Study

Design/Methods: Medline, Embase, and Cochrane Library were searched from inception to February 2024 which reported postoperative complications and other clinical outcomes in patients undergoing spinal surgery and receiving transfusion. We pooled odds ratios, relative risk, hazard ratio, and their corresponding 95% confidence intervals using either fixed- or random-effects models 2 based on I2 value. Study evidence was classified according to the “2011 Oxford Centre for Evidence-Based Medicine Levels of Evidence”.

Results/Findings: In total, 27 studies comprising 185,557 patients fulfilled the inclusion criteria. Moderate quality evidence suggested that blood transfusion was significantly associated with the risk of overall complications(OR 2.63, 95%CI[1.57, 4.39], I2 = 90%), any infection(OR 3.84, 95%CI[3.00, 4. 91], I2 = 25%), surgical site infection(OR 2. 11, 95%CI[1. 57, 2. 84], I2 = 79%), urinary tract infection(OR 2. 30, 95%CI[1. 70, 3. 11], I2 = 0%), sepsis(OR 2. 13, 95%CI[1. 24, 3. 66], I2 = 17%), overall respiratory complication(OR 5. 12, 95%CI[3. 72, 7. 04], I2 = 0%), pneumonia(OR 1. 56, 95%CI[1. 06, 2. 29], I2 = 0%), acute renal failure(OR 2. 48, 95%CI[1. 74, 3. 53], I2 = 48%), and prolonged total length of stay(OR 2. 69, 95%CI[2. 25, 3. 22], I2 = 73%).

Conclusions: Blood transfusion is significantly associated with the risk of multiple postoperative complications in patients undergoig spinal surgery, with an increased risk of prolonged total length of stay. Close monitoring of postoperative complications in spine surgery and enhanced prophylactic strategies should be considered after transfusion.