Risk factors for intraoperative allogeneic blood transfusion during craniotomy for brain tumor removal in children

Background: Several clinical and surgical factors can influence the occurrence of allogeneic blood transfusion ( ABT) during oncologic neurosurgery. Objectives: To identify the potential predictive factors of ABT during craniotomy for the removal of brain tumors in children and the potential impact of intraoperative ABT on early postoperative outcome. Methods: A retrospective study was performed in all pediatric patients younger than 18 years who underwent craniotomy for brain tumor removal from December 2009 to December 2012 in our institution. Pre-, intra-, and postoperative data were collected from medical and stored electronic anesthesia records. The predictors of intraoperative ABT were determined using multivariate logistic regression. Results: A total of 110 patients were included. Twenty- seven patients ( 25%) received intraoperative ABT with a volume of 16 +/- 8 ml center dot kg - 1. On multivariate analysis, an age < 4 years, a duration of surgery > 270 min, and a preoperative hemoglobin < 12.2 g center dot dl - 1 were independently associated with the need for intraoperative ABT. We did not show any significant difference concerning postoperative early outcome and length of stay between the transfused and non- transfused patients except for the duration of postoperative mechanical ventilation that was significantly higher in the transfused group ( P = 0.04). Conclusion: In children, craniotomy for brain tumor removal is at risk of intraoperative ABT. An age < 4 years, a duration of surgery > 270 min, and a preoperative hemoglobin < 12.2 g center dot dl - 1 are the main factors associated with intraoperative ABT during this surgery.