406 Do Earlier Transfusions Improve Post-Operative Outcomes in Long Segment Spinal Fusion Surgery?

INTRODUCTION: Spinal fusion surgeries are among the top surgical procedures to be associated with substantial blood loss, often requiring transfusions. Varying when patients are transfused intra-operatively may alter the post-operative course of patients and decrease rates of morbidity and mortality despite the overall complications associated with transfusions. We hypothesize that patients who are transfused with blood products earlier in the operation will have better post-operative outcomes. METHODS: An IRB-approved retrospective chart review was conducted looking at patients who underwent long segment spine surgeries from 2016-2022. The data examined included patients’ pre-operative comorbidities, intra-operative transfusion details, and post-operative conditions. The severity of post-operative complications was assessed using the Clavien-Dindo Classification. Microsoft Excel (2019) was used for descriptive statistics and analysis. T-tests were used to determine differences between groups with p-value< 0.05 being significant. RESULTS: We first examined outcomes of patients who underwent blood transfusion within an hour into the surgery as opposed to greater than an hour post-initial incision and found that patients who were transfused earlier had significantly less severe post-operative complications (p=0.023). We then compared outcomes of patients who did not receive an ABG before transfusion to patients who had to wait for ABG results before being transfused, and therefore were transfused later. We found that patients who did not receive an ABG had significantly shorter ICU stays (p=0.013) and significantly less severe post-operative complications (p=0.049). CONCLUSIONS: Patients who were transfused sooner into the surgery had better post-operative outcomes. This demonstrates the potential benefits of earlier intra-operative transfusions during long segment spine surgeries.