Association of Intraoperative Blood Transfusions on Postoperative Complications, 30-Day Readmission Rates, and 1-Year Patient-Reported Outcomes

Aladine A. Elsamadicy, Owoicho Adogwa, Victoria D. Vuong, Ankit I. Mehta, Raul A. Vasquez, Joseph Cheng, Carlos A. Bagley, Isaac O. Karikari

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Study Design. Ambispective cohort review. Objective. The aim of this study was to determine the effect of allogeneic red blood cell (RBC) transfusion on postoperative patient complications profiles and 30-day readmission rates following elective spine surgery. Summary of Background Data. Thirty-day hospital readmission rates are being used as a proxy for quality of care. Intra- or perioperative allogeneic RBC transfusions are associated with deleterious effects. Whether allogeneic RBC transfusions are associated with higher perioperative complications and 30-day readmission rates after elective spine surgery remains unknown. Methods. The medical records of 160 patients undergoing elective spine surgery at a major academic medical center were reviewed. Patient demographics, comorbidities, and postoperative complication rates were collected. All patients completed patient-reported outcomes instruments (Oswestry Disability Index, SF-36, and VAS-NP/BP/LP) before surgery, then at 3, 6, and 12 months after surgery. The association between intra- or perioperative allogeneic RBC transfusions and 30-day readmission rate was assessed via multivariate logistic regression analysis. Results. Baseline characteristics were similar in both cohorts. The mean pre- and postoperative hemoglobin levels were lower for the transfusion than nontransfusion cohorts. Postoperative complication rates were 44.67% and 23.00% in the transfusion and nontransfusion cohorts, respectively. Overall, 9.38% of patients were re-admitted within 30 days of hospital discharge, with a three-fold higher increase in 30-day readmission rate in the transfusion cohort compared to the nontransfusion cohort (no transfusion: 5% vs. transfusion: 16.67%, P = 0.01). In a multivariate logistic regression model, intra- or perioperative allogeneic RBC transfusion was an independent predictor of 30-day readmission after elective spine surgery (P = 0.005). Conclusion. Our study suggests that allogeneic RBC transfusions may be associated with increased postoperative complications, length of hospital stay, and 30-day readmission rates.

Original languageEnglish (US)
Pages (from-to)610-615
Number of pages6
JournalSpine
Volume42
Issue number8
DOIs
StatePublished - Apr 15 2017

Fingerprint

Erythrocyte Transfusion
Blood Transfusion
Spine
Logistic Models
Length of Stay
Patient Readmission
Quality of Health Care
Proxy
Medical Records
Patient Reported Outcome Measures
Comorbidity
Hemoglobins
Regression Analysis
Demography

Keywords

  • 30-day readmission
  • allogeneic
  • complications
  • hospital readmission
  • patient-reported outcomes
  • red blood cell transfusions
  • spine surgery

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Elsamadicy, A. A., Adogwa, O., Vuong, V. D., Mehta, A. I., Vasquez, R. A., Cheng, J., ... Karikari, I. O. (2017). Association of Intraoperative Blood Transfusions on Postoperative Complications, 30-Day Readmission Rates, and 1-Year Patient-Reported Outcomes. Spine, 42(8), 610-615. https://doi.org/10.1097/BRS.0000000000001803

Association of Intraoperative Blood Transfusions on Postoperative Complications, 30-Day Readmission Rates, and 1-Year Patient-Reported Outcomes. / Elsamadicy, Aladine A.; Adogwa, Owoicho; Vuong, Victoria D.; Mehta, Ankit I.; Vasquez, Raul A.; Cheng, Joseph; Bagley, Carlos A.; Karikari, Isaac O.

In: Spine, Vol. 42, No. 8, 15.04.2017, p. 610-615.

Research output: Contribution to journalArticle

Elsamadicy, Aladine A. ; Adogwa, Owoicho ; Vuong, Victoria D. ; Mehta, Ankit I. ; Vasquez, Raul A. ; Cheng, Joseph ; Bagley, Carlos A. ; Karikari, Isaac O. / Association of Intraoperative Blood Transfusions on Postoperative Complications, 30-Day Readmission Rates, and 1-Year Patient-Reported Outcomes. In: Spine. 2017 ; Vol. 42, No. 8. pp. 610-615.
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abstract = "Study Design. Ambispective cohort review. Objective. The aim of this study was to determine the effect of allogeneic red blood cell (RBC) transfusion on postoperative patient complications profiles and 30-day readmission rates following elective spine surgery. Summary of Background Data. Thirty-day hospital readmission rates are being used as a proxy for quality of care. Intra- or perioperative allogeneic RBC transfusions are associated with deleterious effects. Whether allogeneic RBC transfusions are associated with higher perioperative complications and 30-day readmission rates after elective spine surgery remains unknown. Methods. The medical records of 160 patients undergoing elective spine surgery at a major academic medical center were reviewed. Patient demographics, comorbidities, and postoperative complication rates were collected. All patients completed patient-reported outcomes instruments (Oswestry Disability Index, SF-36, and VAS-NP/BP/LP) before surgery, then at 3, 6, and 12 months after surgery. The association between intra- or perioperative allogeneic RBC transfusions and 30-day readmission rate was assessed via multivariate logistic regression analysis. Results. Baseline characteristics were similar in both cohorts. The mean pre- and postoperative hemoglobin levels were lower for the transfusion than nontransfusion cohorts. Postoperative complication rates were 44.67{\%} and 23.00{\%} in the transfusion and nontransfusion cohorts, respectively. Overall, 9.38{\%} of patients were re-admitted within 30 days of hospital discharge, with a three-fold higher increase in 30-day readmission rate in the transfusion cohort compared to the nontransfusion cohort (no transfusion: 5{\%} vs. transfusion: 16.67{\%}, P = 0.01). In a multivariate logistic regression model, intra- or perioperative allogeneic RBC transfusion was an independent predictor of 30-day readmission after elective spine surgery (P = 0.005). Conclusion. Our study suggests that allogeneic RBC transfusions may be associated with increased postoperative complications, length of hospital stay, and 30-day readmission rates.",
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AU - Vuong, Victoria D.

AU - Mehta, Ankit I.

AU - Vasquez, Raul A.

AU - Cheng, Joseph

AU - Bagley, Carlos A.

AU - Karikari, Isaac O.

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N2 - Study Design. Ambispective cohort review. Objective. The aim of this study was to determine the effect of allogeneic red blood cell (RBC) transfusion on postoperative patient complications profiles and 30-day readmission rates following elective spine surgery. Summary of Background Data. Thirty-day hospital readmission rates are being used as a proxy for quality of care. Intra- or perioperative allogeneic RBC transfusions are associated with deleterious effects. Whether allogeneic RBC transfusions are associated with higher perioperative complications and 30-day readmission rates after elective spine surgery remains unknown. Methods. The medical records of 160 patients undergoing elective spine surgery at a major academic medical center were reviewed. Patient demographics, comorbidities, and postoperative complication rates were collected. All patients completed patient-reported outcomes instruments (Oswestry Disability Index, SF-36, and VAS-NP/BP/LP) before surgery, then at 3, 6, and 12 months after surgery. The association between intra- or perioperative allogeneic RBC transfusions and 30-day readmission rate was assessed via multivariate logistic regression analysis. Results. Baseline characteristics were similar in both cohorts. The mean pre- and postoperative hemoglobin levels were lower for the transfusion than nontransfusion cohorts. Postoperative complication rates were 44.67% and 23.00% in the transfusion and nontransfusion cohorts, respectively. Overall, 9.38% of patients were re-admitted within 30 days of hospital discharge, with a three-fold higher increase in 30-day readmission rate in the transfusion cohort compared to the nontransfusion cohort (no transfusion: 5% vs. transfusion: 16.67%, P = 0.01). In a multivariate logistic regression model, intra- or perioperative allogeneic RBC transfusion was an independent predictor of 30-day readmission after elective spine surgery (P = 0.005). Conclusion. Our study suggests that allogeneic RBC transfusions may be associated with increased postoperative complications, length of hospital stay, and 30-day readmission rates.

AB - Study Design. Ambispective cohort review. Objective. The aim of this study was to determine the effect of allogeneic red blood cell (RBC) transfusion on postoperative patient complications profiles and 30-day readmission rates following elective spine surgery. Summary of Background Data. Thirty-day hospital readmission rates are being used as a proxy for quality of care. Intra- or perioperative allogeneic RBC transfusions are associated with deleterious effects. Whether allogeneic RBC transfusions are associated with higher perioperative complications and 30-day readmission rates after elective spine surgery remains unknown. Methods. The medical records of 160 patients undergoing elective spine surgery at a major academic medical center were reviewed. Patient demographics, comorbidities, and postoperative complication rates were collected. All patients completed patient-reported outcomes instruments (Oswestry Disability Index, SF-36, and VAS-NP/BP/LP) before surgery, then at 3, 6, and 12 months after surgery. The association between intra- or perioperative allogeneic RBC transfusions and 30-day readmission rate was assessed via multivariate logistic regression analysis. Results. Baseline characteristics were similar in both cohorts. The mean pre- and postoperative hemoglobin levels were lower for the transfusion than nontransfusion cohorts. Postoperative complication rates were 44.67% and 23.00% in the transfusion and nontransfusion cohorts, respectively. Overall, 9.38% of patients were re-admitted within 30 days of hospital discharge, with a three-fold higher increase in 30-day readmission rate in the transfusion cohort compared to the nontransfusion cohort (no transfusion: 5% vs. transfusion: 16.67%, P = 0.01). In a multivariate logistic regression model, intra- or perioperative allogeneic RBC transfusion was an independent predictor of 30-day readmission after elective spine surgery (P = 0.005). Conclusion. Our study suggests that allogeneic RBC transfusions may be associated with increased postoperative complications, length of hospital stay, and 30-day readmission rates.

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KW - complications

KW - hospital readmission

KW - patient-reported outcomes

KW - red blood cell transfusions

KW - spine surgery

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