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This study aimed to provide an overview of transfusion rates across the full diagnostic spectrum and to identify factors influencing transfusion rates with relevance for patient blood management (PBM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      All operated OMFS patients from a five-year period (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913,239) were retrospectively analyzed. Diagnosis-specific transfusion rates were determined, followed by a subgroup analysis of free flap surgeries. Logistic regressions identified factors influencing transfusion rates. ROC analysis in the free flap subgroup determined preoperative hemoglobin cut-off values for increased transfusion risk. Differences in treatment course associated with preoperative anemia were assessed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall transfusion rate was 5.1%. Microvascular free flap surgery was the primary driver of transfusion with a rate of 58.8%, independent of underlying pathologies. Non-oncologic indications requiring free flap reconstruction showed high transfusion rates similar to oncologic indications, whereas the same diagnoses without free flaps had rates\u2009&lt;\u20095%. Free flap reconstruction (OR 5.21) and preoperative anemia (OR 6.25) were the strongest factors influencing transfusion rates. ROC analysis identified preoperative hemoglobin of 12.25\u00a0g\/dl as risk threshold for intraoperative transfusion. Preoperative anemia was associated with a less favorable course regarding intensive care unit treatment, in-hospital mortality and hospital length of stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Transfusion rates in OMFS are generally low but increased in reconstructive free flap surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical relevance<\/jats:title>\n                    <jats:p>These findings offer an evidence base for targeted PBM strategies, including early identification and treatment of preoperative anemia, like intravenous iron therapy in free flap patients, and transfusion rate-adapted blood product preparation to improve perioperative management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00784-026-06902-y","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T15:00:17Z","timestamp":1778684417000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Transfusion rates in oral and maxillofacial surgery and their influencing factors in the context of patient blood management"],"prefix":"10.1007","volume":"30","author":[{"given":"Nils","family":"M\u00f6nnikes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Fenske","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudius","family":"Steffen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vassilisa","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sascha","family":"Treskatsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Heiland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"Rendenbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Pru\u00df","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"issue":"6","key":"6902_CR1","doi-asserted-by":"publisher","DOI":"10.1093\/bjsopen\/zrac128","volume":"6","author":"LV Blum","year":"2022","unstructured":"Blum LV, Schmitt E, Choorapoikayil S, Baumhove O, Bayer A, Friederich P et al (2022) Association of anaemia, co-morbidities and red blood cell transfusion according to age groups: multicentre sub-analysis of the German Patient Blood Management Network Registry. 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The tool was not employed for data analysis, interpretation, or any task that could influence the study\u2019s outcome or conclusions. After using this tool, the authors carefully reviewed and edited the content as required and take full responsibility for the content of the publication.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"S.T. reports honoraria for lectures and workshops by Orion Pharma, Edwards Lifesciences, AOP Health, Cytosorbents, Chiesi, and Philips as well as research funding or grants by the German ministry on Research, Technology and Space, the German ministry for Economic Affairs and Energy, the German Science Foundation, Queen Mary Hospital, Orion Pharma, Becton Dickinson, Cytosorbents, the B. Braun Foundation, and Charit\u00e9; all outside the presented work. All other authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"231"}}