Plastic and Reconstructive Surgery, Global Open (Jan 2020)

Operative Time as the Predominant Risk Factor for Transfusion Requirements in Nonsyndromic Craniosynostosis Repair

  • Yehuda Chocron, MD,
  • Alain J. Azzi, MD,
  • Rafael Galli, MD,
  • Nayif Alnaif, MD,
  • Jeffrey Atkinson, MD, FRCSC,
  • Roy Dudley, MD, FRCSC,
  • Jean-Pierre Farmer, MD, FRCSC,
  • Mirko S. Gilardino, MD, FRCSC

DOI
https://doi.org/10.1097/GOX.0000000000002592
Journal volume & issue
Vol. 8, no. 1
p. e2592

Abstract

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Background:. Despite recent advances in surgical, anesthetic, and safety protocols in the management of nonsyndromic craniosynostosis (NSC), significant rates of intraoperative blood loss continue to be reported by multiple centers. The purpose of the current study was to examine our center’s experience with the surgical correction of NSC in an effort to determine independent risk factors of transfusion requirements. Methods:. A retrospective cohort study of patients with NSC undergoing surgical correction at the Montreal Children’s Hospital was carried out. Baseline characteristics and perioperative complications were compared between patients receiving and not receiving transfusions and between those receiving a transfusion in excess or 25 cc/kg) intraoperative transfusion. Regression analysis revealed that increasing length of surgery was the main determinant for intraoperative (P = 0.008; odds ratio, 18.48; 95% CI, 2.14–159.36) and significant (>25 cc/kg) intraoperative (P = 0.004; odds ratio, 1.95; 95% CI, 1.23–3.07) transfusions. Conclusions:. Our findings suggest increasing operative time as the predominant risk factor for intraoperative transfusion requirements. We encourage craniofacial surgeons to consider techniques to streamline the delivery of their selected procedure, in an effort to reduce operative time while minimizing the need for transfusion.