European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, Jan 29, 2014
Abnormal anthropometry including comparably lower weight and body mass index (BMI) in the adolesc... more Abnormal anthropometry including comparably lower weight and body mass index (BMI) in the adolescent idiopathic scoliosis (AIS) population is increasingly recognised, however, no study has examined postoperative weight loss or its clinical relevance in these relatively thin patients. This study aimed to assess perioperative nutritional status as well as clinically severe involuntary weight loss and its impact on outcomes in patients with AIS undergoing posterior spinal fusion (PSF). A further objective was to compare preoperative anthropometric measurements of the current AIS cohort with healthy controls. Seventy-seven consecutive and eligible patients with AIS who underwent PSF were prospectively followed up from hospital admission (January 2010-April 2012). Pre- and postoperative anthropometric measurements were collected (weight, height, BMI), and clinically severe unintentional weight loss computed, defined as loss of >10 % body weight from admission to hospital discharge. Th...
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Papers by Roslyn Tarrant
Background
Posterior spinal instrumentation and fusion for correction of adolescent idiopathic scoliosis (AIS) typically requires lengthy operating time and may be associated with significant blood loss and subsequent transfusion. This study aimed to identify factors predictive of duration of surgery, intraoperative blood loss and transfusion requirements in an Irish AIS cohort.
Methods
Prospectively collected data were reviewed for a cohort of 77 consecutive patients with AIS who underwent single-stage posterior spinal instrumentation and fusion (PSF) over a two-year period at two Dublin tertiary hospitals. Parameters under analysis included pre- and postoperative radiographic measurements, intraoperative blood loss, surgical duration, blood products required, laboratory blood values and perioperative complications.
Results
Mean preoperative primary curve Cobb angle was 62.3; mean surgical duration was 5.6 hours. The perioperative allogeneic red blood cell transfusion rate was 42.8% with a median requirement of 1 unit. Larger curve magnitudes were positively correlated with longer fusion segments, increased operative time and greater estimated intra-operative blood loss. Pre-operative Cobb angles greater than 70 (Relative Risk [RR] 4.42, p=0.003) and estimated intra-operative blood loss greater than 1,400ml (RR 3.01, p=0.037) were independent predictors of red blood cell transfusion risk.
Conclusion
Larger preoperative curve magnitudes in AIS increase operative time and intraoperative blood loss; preoperative Cobb angles greater than 70o and intraoperative blood loss greater than 1400ml are predictive of red blood cell transfusion requirement in this patient group.
Background
Posterior spinal instrumentation and fusion for correction of adolescent idiopathic scoliosis (AIS) typically requires lengthy operating time and may be associated with significant blood loss and subsequent transfusion. This study aimed to identify factors predictive of duration of surgery, intraoperative blood loss and transfusion requirements in an Irish AIS cohort.
Methods
Prospectively collected data were reviewed for a cohort of 77 consecutive patients with AIS who underwent single-stage posterior spinal instrumentation and fusion (PSF) over a two-year period at two Dublin tertiary hospitals. Parameters under analysis included pre- and postoperative radiographic measurements, intraoperative blood loss, surgical duration, blood products required, laboratory blood values and perioperative complications.
Results
Mean preoperative primary curve Cobb angle was 62.3; mean surgical duration was 5.6 hours. The perioperative allogeneic red blood cell transfusion rate was 42.8% with a median requirement of 1 unit. Larger curve magnitudes were positively correlated with longer fusion segments, increased operative time and greater estimated intra-operative blood loss. Pre-operative Cobb angles greater than 70 (Relative Risk [RR] 4.42, p=0.003) and estimated intra-operative blood loss greater than 1,400ml (RR 3.01, p=0.037) were independent predictors of red blood cell transfusion risk.
Conclusion
Larger preoperative curve magnitudes in AIS increase operative time and intraoperative blood loss; preoperative Cobb angles greater than 70o and intraoperative blood loss greater than 1400ml are predictive of red blood cell transfusion requirement in this patient group.