Establishment and assessment of a nomogram for predicting blood transfusion risk in posterior lumbar spinal fusion

Abstract Background The aim of this study was to determine the risk factors and develop a nomogram for blood transfusions after posterior lumbar spinal fusion (PSL). Methods We conducted retrospective, single-center based on 885 patients receiving PSL, data obtained from May 2015 September 2019. Univariable multivariable logistics regression analysis were identify transfusion, constructed individually evaluate transfusion. Discrimination, calibration, clinical usefulness validated by receiver operating characteristics (ROC), C-index, calibration plot, decision curve analysis, respectively. Bootstrapping validation performed assess performance model. Results Of patients, enrolled in final population, 289 received Statistical analyses showed that low preoperative hemoglobin (Hb), longer time surgery, operative time, levels > 1, surgery duration, higher total intraoperative loss (IBL) C-index 0.898 (95% CI 0.847–0.949) dataset 0.895 bootstrapping validation, Calibration satisfied discrimination nomogram. Decision (DCA) shown utility. Conclusions In summary, we investigated relationship between transfusion requirement predictors: fusion, EBL, Hb level. Our with robust assessment can contribute clinicians making decision. However, external is still needed further.