Evidence map›Paper›PMID 40349263›Full record

ArticleSpine deformity2025

Predictors of massive transfusion of allogenic blood products during posterior spinal fusion in patients with cerebral palsy.

Ali Asma, Nicholas Gajewski, Suken A Shah, Armagan Can Ulusaloglu, Denver B Kraft, Petya K Yorgova, Paul D Sponseller, Amit Jain, Burt Yaszay, Amer F Samdani and 2 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Spine deformity, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Ali AsmaDepartment of Orthopaedics, Nemours Children's Health, Delaware Valley, 1600 Rockland Road, Wilmington, DE, 19803, USA.
Nicholas GajewskiDepartment of Orthopaedics, Nemours Children's Health, Delaware Valley, 1600 Rockland Road, Wilmington, DE, 19803, USA.
Suken A ShahDepartment of Orthopaedics, Nemours Children's Health, Delaware Valley, 1600 Rockland Road, Wilmington, DE, 19803, USA. suken.shah@nemours.org.ORCID http://orcid.org/0000-0003-4885-0138
Armagan Can UlusalogluDepartment of Orthopaedics, Nemours Children's Health, Delaware Valley, 1600 Rockland Road, Wilmington, DE, 19803, USA.
Denver B KraftDepartment of Orthopaedics, Nemours Children's Health, Delaware Valley, 1600 Rockland Road, Wilmington, DE, 19803, USA.
Petya K YorgovaDepartment of Orthopaedics, Nemours Children's Health, Delaware Valley, 1600 Rockland Road, Wilmington, DE, 19803, USA.
Paul D SponsellerJohns Hopkins Medicine, Baltimore, MA, USA.
Amit JainJohns Hopkins Medicine, Baltimore, MA, USA.
Burt YaszaySeattle Childrens' Hospital, Seattle, WA, USA.
Amer F SamdaniShriners Hospitals for Children, Philadelphia, PA, USA.
Firoz MiyanjiBC Children's Hospital, Vancouver, BC, Canada.
Harms Study Group Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis article aimed to determine modifiable risk factors to prevent massive blood transfusion of blood products (MTBP) during spinal fusion in patients with cerebral palsy.

methodsPatient data were queried from a prospectively collected multicenter database. Perioperative MTBP was defined as the administration of allogenic blood products equaling at least half (50%) of the patients' preoperative blood volume during the surgical procedure. Univariate and multivariate logistic regression was used for statistical analysis.

resultsThree hundred thirty-three patients were included. Ninety-four percent of patients were Gross Motor Classification System IV and V. The incidence of MTBP was 29.7% (99/333). The lack of antifibrinolytic use was significant at univariate analysis. Preoperative low weight, blood volume loss, hybrid system, and unit rod use remained significant after the adjustment in multivariate analysis. Loss of more than 68% of patient blood volume was the threshold for MTBP. Patients receiving MTBP had increased hospital (P = 0.006) and intensive care unit (P < 0.001) stays. However, surgical site complications, deep wound infections, and reoperation rate were not different (P = 0.12, P = 0.46, P = 0.22, respectively). There was a significant decrease in MTBP incidence from 2008 (53%) to 2016 (11%) (P < 0.001) with routine administration of antifibrinolytics.

conclusionThe incidence of MTBP in patients with cerebral palsy undergoing PSF during the study period was 29.7% and this rate has decreased over time, making the surgery safer. Optimization of preoperative nutrition status, use of pedicle screw constructs when possible, and use of antifibrinolytics when not contraindicated is recommended to reduce the risk of perioperative MTBP. LEVEL OF EVIDENCE: Level III-Retrospective cohort study.

Indexed as

Blood Loss, SurgicalBlood TransfusionCerebral PalsySpinal FusionAdolescentAdultChildFemaleHumansMaleRetrospective StudiesRisk FactorsYoung AdultAllogenicBlood lossCerebral palsyMassive transfusionNon-ambulatoryPedicle screwScoliosisSpinal fusionUnit rodWeight

Identifiers

PMID40349263

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.