Transfusion of older red blood cells increase the risk of postoperative infectious complications in pediatric scoliosis surgery: a propensity score matched analysis

Abstract Purpose: Pediatric scoliosis patients undergoing posterior spinal fusion surgery often need RBCs transfusion. However, the effects of storage time of transfused blood on perioperative outcomes remain undefined.Methods: A retrospective study including 539 pediatric patients undergoing posterior spinal fusion surgery was conducted. These patients were divided into 2 groups: the fresh group, who received exclusively blood cells stored for 14 days or less; the older group, who received exclusively blood for more than 14 days. The effect of red blood cell storage time on length of hospital stay and postoperative complications was analyed by propensity score matching. Results: The propensity score matching yielded 78 well-matched pairs after adjusting for potential confounders in baseline characteristics. Patients who received older blood had not prolonged length of stay compared with those received fresh blood (13.0 ± 3.8 days vs 11.8 ± 2.6 days, p = 0.09). However, multivariable logistic regression analysis showed that older group had a higher incidence of infectious complications compared with fresh group (OR = 2.15 [95% CI, 1.08–4.31]; P = 0.029). Conclusions: In pediatric scoliosis patients undergoing posterior spinal fusion surgery, transfusion of older RBCs had a higher incidence of postoperative infectious complications but was not associated with prolonged length of hospital stay.