Imperial College London

DrRichardPinder

Faculty of MedicineSchool of Public Health

Director of Undergraduate Public Health Education
 
 
 
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Contact

 

+44 (0)20 7594 0789richard.pinder

 
 
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Location

 

313Reynolds BuildingCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Dick:2019:10.1177/2192568219837488,
author = {Dick, A and Pinder, R and Ember, T and Lyle, S and Mallinson, C and Lucas, J},
doi = {10.1177/2192568219837488},
journal = {Global Spine Journal},
pages = {843--849},
title = {Reducing allogenic blood transfusion in paediatric scoliosis surgery – reporting fifteen years of a multidisciplinary, evidence based quality improvement project},
url = {http://dx.doi.org/10.1177/2192568219837488},
volume = {9},
year = {2019}
}

RIS format (EndNote, RefMan)

TY  - JOUR
AB - Study Design:Retrospective review of prospectively collected spinal surgery and transfusion databases.Objectives:To evaluate the efficacy of a care pathway developed at our institution since 2003 with a focus on reducing the need for blood transfusions in children undergoing scoliosis correction surgery. The care pathway includes nurse-led clinics facilitating preoperative hemoglobin optimization, intraoperative cell salvage, the use of tranexamic acid, and a transfusion criteria awareness program.Methods:Retrospective review of our institution’s prospectively recorded spinal surgery and transfusion databases including all cases of scoliosis surgery in patients 18 years and younger between 2001 and 2015.Results:A total of 1039 procedures were included in the analysis. Overall, 24.4% of patients received a transfusion. The proportion of patients transfused was 89.2% in 2001-2003, 39.6% in 2004-2006, 16.5% in 2007-2009, 15.6% in 2010-2012, and 20.1% in 2013-2015. The volume of blood products transfused in those undergoing transfusion was 9.1 units in 2001-2003, 4.8 units in 2004-2006, 5.0 units in 2007-2009, 2.3 units in 2010-2012, and 2.1 units in 2013-2015. A multivariate logistic regression demonstrated adjusted odds ratios for the probability of receiving any transfusion of 5.45 (95% confidence interval 3.62-8.11) for patients with neuromuscular diagnoses and 11.17 (5.02-24.86) for those undergoing combined anterior and posterior surgical approach.Conclusions:We have demonstrated over a 15-year period that the introduction of a multifaceted, multidisciplinary pathway can dramatically and sustainably reduce the need for blood transfusions and their attendant risks in pediatric scoliosis surgery. This data lends weight to the adoption of such a care pathway in pediatric scoliosis surgery.
AU - Dick,A
AU - Pinder,R
AU - Ember,T
AU - Lyle,S
AU - Mallinson,C
AU - Lucas,J
DO - 10.1177/2192568219837488
EP - 849
PY - 2019///
SN - 2192-5682
SP - 843
TI - Reducing allogenic blood transfusion in paediatric scoliosis surgery – reporting fifteen years of a multidisciplinary, evidence based quality improvement project
T2 - Global Spine Journal
UR - http://dx.doi.org/10.1177/2192568219837488
UR - http://hdl.handle.net/10044/1/67997
VL - 9
ER -