Allogeneic Transfusion-related Adverse Events in Pediatric Idiopathic Scoliosis Surgery

Background Pediatric spinal deformity surgery can involve significant perioperative blood loss, and allogeneic blood transfusion has been linked to an increased risk of adverse events. This study aimed to quantify adverse events associated with allogeneic blood transfusion in pediatric idiopathic scoliosis surgery.Study design/setting Retrospective observational cohort study.Methods The National Surgical Quality Improvement Program (NSQIP) Pediatric database (2016-2022) was queried. Patients Results A total of 23,106 patients were included in this study, of which 12.3% received allogeneic transfusion. The rate of the composite 30-day adverse event outcome was 1.1%. Patients that received allogeneic transfusion had a higher rate of 30-day adverse event (2.5% vs 0.9%; X2 ​= ​62.5, P ​P ​Conclusions In this large national pediatric registry cohort, allogeneic transfusion was associated with higher odds of 30-day adverse events after posterior spinal fusion for idiopathic scoliosis. Further prospective and center-level studies are needed to clarify transfusion thresholds, blood management strategies, and potential contributors to adverse outcomes.Key concepts (1)In 23,106 pediatric idiopathic scoliosis patients from the American College of Surgeons National Surgical Quality Improvement Program, 12.3% received allogeneic transfusion and the overall 30-day composite adverse event rate was 1.1%.(2)Patients who received allogeneic transfusion had a significantly higher rate of composite 30-day adverse events compared to those who did not (2.5% vs 0.9%, P ​P ​Level of evidence Level III.