Pre-operative Hematocrit is Predictive of Intra-operative Bleeding in Pediatric Scoliosis Spinal Fusion

Introduction: Spinal fusion in children with scoliosis is a common surgical procedure that is frequently complicated by significant blood loss. Increased blood loss has been correlated to higher rates of post-operative complications. Our present study investigates the relationship between pre-operative hematocrit and the likelihood that a patient requires transfusion or experiences significant peri-operative bleeding.

Methods: We performed a retrospective analysis of the National Surgical Quality Improvement Program Pediatric database between 2016-2020 for pediatric patients undergoing scoliosis treatment.

Results: We identified 3182 patients undergoing treatment for scoliosis. Patients with a hematocrit between 35-45 had the lowest amount of bleeding and need for transfusions. Patients with a hematocrit outside of 35-45 were 1.5 times more likely to require transfusion or have significant intra-operative bleeding (p < 0.001).

Conclusion : Our study found that pediatric patients with a hematocrit between 35-45 were less likely to require blood transfusions or experience significant peri-operative bleeding. Surgeons can improve the likelihood of positive patient outcomes by pre-operatively optimizing their hematocrit prior to treating scoliosis.