Abstract: Objective To investigate the perioperative rate of allogeneic red blood cell (RBC) transfusion in adolescent scoliosis(AS) that underwent posterior correction surgeries, and to identify its risk factors. Methods This study was a retrospective cohort study. Anesthetic data of adolescent scoliosis patients who underwent posterior correction surgeries from January 2015 to May 2017 in Peking Union Medical College Hospital were collected and analyzed. The clinical variables were subsequently compared between patients who received allogeneic RBC transfusion(transfusion group) and those who did not (non-transfusion group). Binary logistic regression analysis was performed to identify risk factors in perioperative allogeneic RBC transfusion in these patients. Results The study enrolled 469 patients. The perioperative rate of allogeneic RBC transfusion was 30.5% and the independent risk factors leading to it included corrected body mass index (BMI) (OR=0.887, 95% CI: 0.815-0.966, P＜0.01),other type of scoliosis (OR=3.847, 95% CI: 1.660-8.917, P＜0.01) (compared with idiopathic scoliosis), preoperative anemia (OR=6.322, 95% CI: 2.053-19.473, P＜0.01), the number of fused levels more than 12.5 (OR=3.554, 95% CI: 2.174-5.885, P＜0.001), preoperative Cobb angle larger than 64.5° (OR=2.381, 95% CI: 1.356-4.178, P＜0.01) and osteotomy (OR=7.551, 95% CI: 3.258-17.503,P＜0.001). The postoperative transfer rate to intensive care unit(ICU)(P＜0.001) in transfusion group was higher, with longer hospital stay length(P＜0.001) and higher cost(P＜0.001), than that in the non-transfusion group. Conclusions The risk factors for perioperative allogeneic RBC transfusion in AS include corrected BMI, other type of scoliosis, preoperative anemia, the number of fused levels more than 12.5, preoperative Cobb angle larger than 64.5° and osteotomy.

Key words: adolescent, scoliosis, posterior correction surgery, allogeneic red blood cell(RBC) transfusion