Factores asociados a transfusión sanguínea en el manejo quirúrgico del canal lumbar estrecho en la Fundación Santa Fe de Bogotá 2003 - 2013

Abstract

Introduction: The lumbar spinal canal stenosis is a frequent pathology in the spine service of Hospital Fundación Santa Fe de Bogotá. Surgical treatment can generate multiple complications, including blood transfusions as one of the most common. Objective: To identify sociodemographic factors, personal history and surgical factors associated with blood transfusion in in patients who undergo surgery for lumbar spinal canal stenosis in the Hospital Fundación Santa Fe de Bogotá from 2003 to 2013. Materials and Métodos: A cross-sectional observational study was conducted 367 patients undergoing surgery for lumbar spinal stenosis were analyzed, personal background variables, sociodemographic characteristics and quirugic factors were included. Results: The median age was 57 years and most patients were women (55.6 %). The median Body Mass Index (BMI) was 24.9 classified as normal. Among the medical historia, hypertension was the most common (37.3 %). Most patients (59.1 %) were ASA II classification. The most prevalent type surgery was decompression (55.6 %). In the 79.8 % of patients were operated two levels. Transfusion was performed in 26 patients corresponding to 7.1% of all patients. In most surgical procedures (42.5 %) bleeding was classified as moderate (50-500 ml). History of heart disease (OR 4.68, CI 1.12 to 19.44), intraoperative bleeding > 500ml (OR 6.74, CI 2,09 to 21.74) and >2 operated levels (OR 3.97, CI 1.20 to 13.09) are the risk factors related to the need of blood transfusion. Conclusion: Factors associated with blood transfusion in the surgical management of lumbar spinal stenosis from the experience of 10 years in Fundacion Santa Fe de Bogota are heart disease, intraoperative bleeding more than 500ml and more than two quirurgic levels .