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J Neurol Surg B Skull Base 2018; 79(06): 599-605
DOI: 10.1055/s-0038-1651502
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Red Blood Cell Transfusions Following Resection of Skull Base Meningiomas: Risk Factors and Clinical Outcomes

Carlito Lagman
1   Department of Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, California, United States
,
John P. Sheppard
1   Department of Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, California, United States
,
Joel S. Beckett
1   Department of Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, California, United States
,
Alexander M. Tucker
1   Department of Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, California, United States
,
Daniel T. Nagasawa
1   Department of Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, California, United States
,
Giyarpuram N. Prashant
1   Department of Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, California, United States
,
Alyssa Ziman
2   Wing-Kwai and Alice Lee-Tsing Chung Transfusion Service, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, United States
,
Isaac Yang
1   Department of Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, California, United States
3   Head and Neck Surgery, Ronald Reagan UCLA Medical Center, Los Angeles, California, United States
4   Radiation Oncology, Ronald Reagan UCLA Medical Center, Los Angeles, California, United States
5   UCLA Jonsson Comprehensive Cancer Center, Ronald Reagan UCLA Medical Center, Los Angeles, California, United States
6   Department of Neurosurgery at Harbor UCLA Medical Center, Torrance, California, United States
7   Los Angeles Biomedical Research Institute (LA BioMed) at Harbor UCLA Medical Center, Torrance, California, United States
› Author Affiliations Funding Carlito Lagman is supported by the Tina and Fred Segal Benign Brain Tumor & Skull Base Surgery Research Fellowship. John P. Sheppard is supported by the David Geffen Medical Scholarship. Isaac Yang is partially supported by the UCLA Visionary Ball Fund Grant, Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research UCLA Scholars in Translational Medicine Program Award, Jason Dessel Memorial Seed Grant, UCLA Honberger Endowment Brain Tumor Research Seed Grant, and Stop Cancer (US) Research Career Development Award.
Further Information

Publication History

30 November 2017

31 March 2018

Publication Date:
14 May 2018 (online)

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Abstract

Objective This article identifies risk factors for and investigates clinical outcomes of postoperative red blood cell transfusion in patients with skull base meningiomas.

Design Retrospective cohort study.

Setting Single academic medical center.

Participants The transfusion group included patients who had skull base meningiomas and who received packed red blood cell (RBC) transfusion within 7 days of surgery. The no transfusion group included patients who had skull base meningiomas but who did not have RBCs transfused within 7 days of surgery.

Main Outcome Measures In-hospital complication rate, length of stay (LOS), and discharge disposition.

Results One hundred and ninety-six patients had a craniotomy for resection of a meningioma at our institution from March 2013 to January 2017. Seven patients had skull base meningiomas and received RBC transfusion within 7 days of surgery (the transfusion group). The skull base was an independent risk factor for transfusion after we controlled for the effect of meningioma size (OR 3.89, 95% CI 1.34, 11.25). Operative time greater than 10 hours was an independent risk factor for prolonged hospital stay (OR 8.84, 95% CI 1.08, 72.10) once we controlled for the effect of transfusion. In contrast, transfusion did not independently impact LOS or discharge disposition once we controlled for the effect of operative time.

Conclusions The skull base is an independent predictor of RBC transfusion. However, RBC transfusion alone cannot predict LOS or discharge disposition in patients who undergo surgical resection of a skull base meningioma.

Keywords

blood transfusion - meningioma - surgery - skull base
 

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