Gülsüm Merve ÜNAL, Nesil COŞKUN FIRAT, Zekiye BİGAT, İlker ÖNGÜÇ AYCAN, Yeşim ÇETİNTAŞ

Travmatik Vertebra Fraktürü Nedeniyle Yapılan Vertebra Cerrahilerinde Allojenik Kan Transfüzyonları

Amaç: Travmatik vertebra cerrahisi(TVC); intraoperatif kan kaybının en önemli sebeplerinden biridir ve genellikle allojenik kan transfüzyonu gereklidir. Biz bu çalışmada intraoperatif allojenik kan transfüzyonlarını(IOAKT) etkileyen faktörleri belirlemek ve IOAKT' nin kısa vadeli postoperatif sonuçlar üzerindeki etkilerini gözlemlemek istedik. Yöntem: Bu retrospektif çalışmada TVC uygulanan 203 hasta belirlenmiştir ve verileri eksik olan 58 hasta çalışma dışı bırakılmıştır. Preoperatif ve intraoperatif değişkenlerin IOAKT insidansı üzerine etkilerini, IOAKT ile postoperatif mekanik ventilasyon(MV) süreleri, Yoğun Bakım Ünitesi(YBÜ) kalış süreleri ve taburculuk süreleri arasındaki ilişki değerlendirilmiştir. Bulgular: 145 hasta değerlendirildi. İOAKT+(n=25) ve İOAKT-(n=120) olan iki grup arasında yaş (p= 0,171), cinsiyet (p=0,471 ), ASA sınıflaması, cerrahi yapılan segment sayısı (p=0,068), cerrahi yaklaşım şekli arasında istatistiksel olarak anlamlı fark bulunmamıştır. Preoperatif hemoglobin düzeyleri sırasıyla 12,25 ± 1,78 g/dL ve 12,97 ± 1,84 g/dL idi(p = 0,076). İOAKT+ grubun ortalama operasyon süresi anlamlı derecede uzun bulunmuştur(p ˂ 0,022). İOABT+ grubun hastaneden taburculuk süresi anlamlı derecede uzun bulunmuştur(14 ve 9 gün). İki grup arasında YBÜ’ de kalma süreleri(p=0,624) ve MV süreleri(p=0,555) arasında anlamlı fark bulunmamıştır. Sonuç: Allojenik kan transfüzyonu, hastaların preoperatif hemoglobin seviyeleri ve ameliyatın büyüklüğünden bağımsız olarak; daha uzun hastanede yatış süresi için bağımsız bir risk faktörü olabilir. Kan kaybını ve kan transfüzyonunu önleme stratejileri, maliyetlerin düşmesi ile sonuçlanabilir.

Allogeneic Blood Transfusions in Traumatic Vertebral Fracture Surgery

Objective: Intraoperative blood loss is one of the most important problems in traumatic vertebral surgery(TVS) and usually allogenic blood transfusion is needed. In this study, we aimed to determine the factors that affect intraoperative allogeneic blood transfusions(IOABT) and the effects of IOABT on the short-term postoperative outcome. Material and Methods: In this retrospective study 203 patients that underwent TVS were determined and 58 with missing data were excluded. The effects of pre and intraoperative variables on the incidence of IOABTs and the relation of IOABT and postop- erative mechanical ventilation times, length of Intensive Care Unit( ICU) stay and discharge times were evaluated. Results: 145 patients were evaluated. There was no significant differ- ence between IOABT+ (n=25) and IOABT– (n=120) patients regarding age (p =0.171), gender (p=0.471), ASA status, operated vertebral segment levels(p=0.068) and surgical approach. Preoperative hemoglobin levels were 12.25 ±SD 1.78 g/dl and 12.97 SD±1.84 g/dL respectively (p=0.076). IOABT+ patients had significantly long operation times (p ˂ 0.022). IOABT+ group had significantly longer (14 vs 9 days, (p

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