Perioperative blood transfusion does not decrease survival after surgical treatment of spinal metastases

PURPOSE: To assess whether perioperative allogenic blood transfusions in patients undergoing surgical treatment for spinal metastases independently influence patient survival.

METHODS: A retrospective study including 170 consecutive patients undergoing surgical treatment for spinal metastases in 2009 and 2010 at a tertiary referral center. Variables related to postoperative survival were all included in the same multivariable logistic regression analysis with either 3- or 12-month survival as the dependent variable. The independent variables were: transfusion of allogenic red blood cells, age at surgery, gender, preoperative hemoglobin, revised Tokuhashi score and no. of instrumented levels.

RESULTS: Perioperative allogenic blood transfusion of 1-2 units was associated with increased 12-month survival [p = 0.049, odds ratio 2.619 (confidence interval 1.004-6.831)], but not with 3-month survival. Larger transfusion volumes did not significantly influence survival.

CONCLUSION: The results of the present study support that perioperative blood transfusion of <5 units does not decrease survival in patients operated for spinal metastases. Transfusion of 1-2 units seems to be associated with increased 12-month survival. Future studies should assess if a liberal transfusion regime can be applied to this group of patients; thereby, prioritizing early postoperative mobilization.