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Antifibrinolytic Drugs and Allogeneic Transfusion in Pediatric Multilevel Spine Surgery: A Propensity Score Matched Cohort Study.

Abstract:

STUDY DESIGN:Observational cohort study with propensity score matching. OBJECTIVE:Determine whether antifibrinolytic drug use is associated with decreased allogeneic blood transfusion in multilevel pediatric spine surgery. SUMMARY OF BACKGROUND DATA:Antifibrinolytic drugs are commonly used in adult multilevel spine surgery to reduce blood loss and allogeneic transfusion; however, only small studies have examined their efficacy in pediatric patients having multilevel spine surgery. METHODS:Pediatric patients who had posterior multilevel spine surgery between 2016 and 2017 were identified in the national surgery quality improvement program participant use file. Propensity score matching was used to reduce bias from confounding and the rate of intraoperative allogeneic transfusion was compared between patients who received antifibrinolytic drugs and those who did not. Secondary outcomes included intraoperative cell saver volume, postoperative allogeneic transfusion, massive intraoperative transfusion, and adverse events including venous thromboembolism and seizure. RESULTS:A total of 6904 patients underwent posterior multilevel spine surgery during the study period and 83% received antifibrinolytics. The matched cohort included 604 patients. Antifibrinolytic use had no association with reduced intraoperative allogeneic transfusion: odds ratio (OR) = 0.71 (99% confidence interval [CI] = 0.40-1.26, P = 0.12) or cell saver volume, median volume = 114 mL (0, 250 mL) in antifibrinolytic group versus 100 mL (0, 246 mL) in control group, P = 0.04. There was also no association with reduced postoperative allogeneic transfusion OR = 1.23 (99% CI = 0.54-2.81, P = 0.52) or massive transfusion OR = 1.0 (99% CI = 0.34-2.92, P = 1.0). No patient in the matched cohort had a venous thromboembolism or seizure. CONCLUSION:Antifibrinolytic drugs are commonly used in pediatric multilevel spine surgery in the United States, but no efficacy was demonstrated in our study. There were no venous thromboembolisms or seizures implying an excellent safety profile in pediatric patients. LEVEL OF EVIDENCE:3.

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SPINE

最新影响因子：3.241	期刊ISSN：0362-2436	CiteScore：2.79
出版周期：Semimonthly	是否OA：YES	出版年份：1976

期刊官方网址：http://journals.lww.com/spinejournal/pages/default.aspx

期刊投稿地址：http://www.editorialmanager.com/spine/

自引率：12.40%	研究方向：医学-临床神经学
出版地区：UNITED STATES

SCI期刊coverage：Science Citation Index Expanded（科学引文索引扩展）

NCBI查询：PubMed Central (PMC)链接全文检索(pubmed central)

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SPINE 期刊简介

英文简介：

Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.

中文简介：（来自Google、百度翻译）

《脊柱》是国际上公认的脊柱领域的领先期刊，是一种国际性的、同行评审的、双周刊，考虑出版脊柱领域的原创文章。它是治疗脊柱疾病的领先的子专业杂志。只有原创论文才会被考虑出版，但前提是这些论文只对脊柱有贡献。《华尔街日报》不发表在其他地方发表过长篇报道的文章。

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SPINE 期刊中科院评价数据

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SPINE 期刊CiteScore评价数据

CiteScore排名

序号	类别	排名	百分位
1	大类(学科)：Medicine 小类(学科)：Orthopedics and Sports Medicine	#26/237 点击查看排名表	89th
2	大类(学科)：Medicine 小类(学科)：Neurology (clinical)	#85/336 点击查看排名表	74th

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Scopus涵盖范围

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SPINE 期刊常见问题

权益保障

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15年经验沉淀，实体公司
运营

SPINE 投稿经验

(由下方点评分析获得，17人参与，47432人阅读）

偏重的研究方向：

脊柱 (2) 脊柱外科 (1) 基础类 (1) 生化 (1) 基础 (1) 临床 (1) 脊柱临床 (1) 脊柱基础 (1) 脊柱感染的影响学表现 (1) 头颈交界 (1) 影像诊断 (1)
投稿录用比例：

暂无
审稿速度：

平均4.3333333333333个月的审稿周期(非官方数据)

年度总发文量	年度论文发表量	年度综述发表量
497	480	17

Antifibrinolytic Drugs and Allogeneic Transfusion in Pediatric Multilevel Spine Surgery: A Propensity Score Matched Cohort Study.