{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:09:02Z","timestamp":1777658942597,"version":"3.51.4"},"reference-count":33,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2019,4,14]],"date-time":"2019-04-14T00:00:00Z","timestamp":1555200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Retrospective review of prospectively collected spinal surgery and transfusion databases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To evaluate the efficacy of a care pathway developed at our institution since 2003 with a focus on reducing the need for blood transfusions in children undergoing scoliosis correction surgery. The care pathway includes nurse-led clinics facilitating preoperative hemoglobin optimization, intraoperative cell salvage, the use of tranexamic acid, and a transfusion criteria awareness program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Retrospective review of our institution\u2019s prospectively recorded spinal surgery and transfusion databases including all cases of scoliosis surgery in patients 18 years and younger between 2001 and 2015.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 1039 procedures were included in the analysis. Overall, 24.4% of patients received a transfusion. The proportion of patients transfused was 89.2% in 2001-2003, 39.6% in 2004-2006, 16.5% in 2007-2009, 15.6% in 2010-2012, and 20.1% in 2013-2015. The volume of blood products transfused in those undergoing transfusion was 9.1 units in 2001-2003, 4.8 units in 2004-2006, 5.0 units in 2007-2009, 2.3 units in 2010-2012, and 2.1 units in 2013-2015. A multivariate logistic regression demonstrated adjusted odds ratios for the probability of receiving any transfusion of 5.45 (95% confidence interval 3.62-8.11) for patients with neuromuscular diagnoses and 11.17 (5.02-24.86) for those undergoing combined anterior and posterior surgical approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>We have demonstrated over a 15-year period that the introduction of a multifaceted, multidisciplinary pathway can dramatically and sustainably reduce the need for blood transfusions and their attendant risks in pediatric scoliosis surgery. This data lends weight to the adoption of such a care pathway in pediatric scoliosis surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2192568219837488","type":"journal-article","created":{"date-parts":[[2019,4,15]],"date-time":"2019-04-15T01:50:54Z","timestamp":1555293054000},"page":"843-849","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["Reducing Allogenic Blood Transfusion in Pediatric Scoliosis Surgery:: Reporting 15 Years of a Multidisciplinary, Evidence-Based Quality Improvement Project"],"prefix":"10.1177","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3968-4193","authenticated-orcid":false,"given":"Alastair G.","family":"Dick","sequence":"first","affiliation":[{"name":"Guy\u2019s & St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard J.","family":"Pinder","sequence":"additional","affiliation":[{"name":"Imperial College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9678-3158","authenticated-orcid":false,"given":"Shirley A.","family":"Lyle","sequence":"additional","affiliation":[{"name":"Guy\u2019s & St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Ember","sequence":"additional","affiliation":[{"name":"Guy\u2019s & St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Mallinson","sequence":"additional","affiliation":[{"name":"Guy\u2019s & St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Lucas","sequence":"additional","affiliation":[{"name":"Guy\u2019s & St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,4,14]]},"reference":[{"key":"bibr1-2192568219837488","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-004-0760-y"},{"key":"bibr2-2192568219837488","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-016-4899-0"},{"key":"bibr3-2192568219837488","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200210010-00012"},{"key":"bibr4-2192568219837488","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.8.959"},{"key":"bibr5-2192568219837488","doi-asserted-by":"publisher","DOI":"10.1097\/01.TA.0000022460.21283.53"},{"key":"bibr6-2192568219837488","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeh290"},{"key":"bibr7-2192568219837488","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200007000-00035"},{"key":"bibr8-2192568219837488","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e3054"},{"key":"bibr9-2192568219837488","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-16-00035"},{"key":"bibr10-2192568219837488","unstructured":"Pinder R, Mallinson C, Lucas J, Lyle S. A multi-disciplinary approach to improving blood transfusion practice in paediatric scoliosis correction surgery. 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