Effects of race on blood loss in spinal fusions for adolescent idiopathic scoliosis

Neil Kaushal; Keith J Orland; Andrew M Schwartz; Jacob M Wilson; Nicholas D Fletcher; Anuj Patel; Bryan Menapace; Michelle Ramirez; Martha Wetzel; Dennis Devito; Joshua Murphy

doi:10.3171/2020.7.PEDS2049

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Effects of race on blood loss in spinal fusions for adolescent idiopathic scoliosis

Journal article

Open access

Peer reviewed

Effects of race on blood loss in spinal fusions for adolescent idiopathic scoliosis

Neil Kaushal, Keith J Orland, Andrew M Schwartz, Jacob M Wilson, Nicholas D Fletcher, Anuj Patel, Bryan Menapace, Michelle Ramirez, Martha Wetzel, Dennis Devito, …

Journal of neurosurgery. Pediatrics, Vol.27(2), pp.213-217

11/06/2020

DOI: 10.3171/2020.7.PEDS2049

PMID: 33157524

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Abstract

Posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) can be associated with significant blood loss. It has been suggested that blood loss is greater in different racial groups. The purpose of this study was to evaluate differences in blood loss between African American and Caucasian patients undergoing PSF for AIS. A retrospective review was performed of patients aged 10-18 years with AIS who were treated with PSF from 2014 to 2017 at a single children's healthcare system. Patient demographic, radiographic, and operative data were obtained from medical records. Intraoperative blood loss was calculated using the formula described by Waters et al. Patients who declined reporting their race or had prior spinal surgery, neuromuscular or syndromic diagnoses, a history of cardiac or thoracic surgery, or a bleeding disorder were excluded. Blood loss variables were log-transformed for normality and modeled using multivariable linear regression. A total of 433 PSFs for AIS qualified for the analysis. The average age was 14.1 years, and 73.7% of the patients were female. With respect to race, 44.6% identified themselves as African American. There was no significant difference in blood loss (p = 0.31) or blood loss per level fused (p = 0.36) in African American patients. African American patients, however, did have significantly lower preoperative hemoglobin and hematocrit levels and greater operating room time than Caucasian patients (p < 0.001). There was no difference between race and transfusion rate. There appears to be no relationship between race and blood loss during PSF for AIS. Standardized protocols for minimizing perioperative blood loss can be applied to both Caucasian and African American patients.

African Americans

United States

Adolescent

Blood Loss, Surgical - statistics & numerical data

Blood Transfusion - statistics & numerical data

Child

Ethnicity

Female

Hematocrit

Hemoglobins - analysis

Humans

Kyphosis

Male

Retrospective Studies

Scoliosis - surgery

Spinal Fusion - adverse effects

Spinal Fusion - methods

Treatment Outcome

Whites

Details

Title: Subtitle: Effects of race on blood loss in spinal fusions for adolescent idiopathic scoliosis
Creators: Neil Kaushal - Rutgers, The State University of New Jersey
Keith J Orland - Emory University
Andrew M Schwartz - Emory University
Jacob M Wilson - Emory University
Nicholas D Fletcher - Children's Healthcare of Atlanta
Anuj Patel - Emory University School of Medicine
Bryan Menapace - University of Cincinnati
Michelle Ramirez - Atlanta Medical Center
Martha Wetzel - Children's Healthcare of Atlanta
Dennis Devito - Children's Healthcare of Atlanta
Joshua Murphy - Children's Healthcare of Atlanta
Resource Type: Journal article
Publication Details: Journal of neurosurgery. Pediatrics, Vol.27(2), pp.213-217
DOI: 10.3171/2020.7.PEDS2049
PMID: 33157524
NLM abbreviation: J Neurosurg Pediatr
ISSN: 1933-0707
eISSN: 1933-0715
Language: English
Date published: 11/06/2020
Academic Unit: Orthopedics and Rehabilitation
Record Identifier: 9984303984002771

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