Predictors of Red Blood Cell Transfusion in Bimaxillary Orthognathic Surgery: A Retrospective Study

Int J Med Sci. 2021 Jan 29;18(6):1432-1441. doi: 10.7150/ijms.55567. eCollection 2021.

Abstract

Background: Orthognathic surgery requires red blood cell (RBC) transfusions more frequently than other oral and maxillofacial surgeries. The purpose of this study was to identify reliable predictors for RBC transfusion during bimaxillary orthognathic surgery (BOS). Methods: This retrospective study reviewed 1,616 electronic medical records of patients who underwent BOS during a 5-year period at Seoul National University Dental Hospital. The perioperative variable data were collected from electronic medical records and analyzed by dividing patients into the two groups (non-transfusion and transfusion group). Results: Of the 1,616 patients, 1,311 patients were excluded. The remaining 305 patients were divided into non-transfusion (NTF, n = 256) and transfusion (TF, n = 49) groups. Univariate logistic regression analysis revealed that age, body mass index, the presence of several adjunctive surgeries (including genioplasty, extraction, and mandibular angle reduction), preoperative hemoglobin (Hb) and prothrombin time, surgical time, amount of fluid infusion and blood loss, and mean pulse rate during surgery were significant factors predicting RBC transfusion. Multivariate logistic regression analysis revealed that preoperative Hb and blood loss amount during surgery were significantly related to RBC transfusion in BOS patients. Conclusion: Since blood loss amounts could not be measured preoperatively, we found that the independent predictor associated with RBC transfusion during BOS was a low preoperative Hb level.

Keywords: blood transfusion; hemoglobins; orthognathic surgery; red blood cell.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Blood Loss, Surgical / prevention & control
  • Blood Loss, Surgical / statistics & numerical data*
  • Body Mass Index
  • Erythrocyte Transfusion / statistics & numerical data*
  • Female
  • Hemoglobins / analysis*
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Operative Time
  • Orthognathic Surgical Procedures / adverse effects*
  • Preoperative Period
  • Prothrombin Time
  • Reproducibility of Results
  • Retrospective Studies
  • Risk Assessment / methods
  • Risk Factors
  • Young Adult

Substances

  • Hemoglobins