Blood transfusion guidelines in skull base surgery: a scoping review.
| Publication Type | Review |
| Authors | Gundlach C, Poulson T, Bah M, Newome-Cuby T, Eraghi M, Michel M, Nilchian P, Farid M, Azam F, AlDallal U, Anand S, O'Leary S, Barrie U, Aoun S |
| Journal | J Clin Neurosci |
| Volume | 140 |
| Pagination | 111522 |
| Date Published | 07/28/2025 |
| ISSN | 1532-2653 |
| Keywords | Blood Transfusion, Skull Base, Neurosurgical Procedures, Practice Guidelines as Topic |
| Abstract | OBJECTIVE: Consensus guidelines are lacking for the administration of blood product transfusions in adult skull base neurosurgery. This study aims to synthesize the current literature and provide preliminary evidence-based considerations for blood product transfusions in skull base surgery. METHODS: A scoping review was conducted using PubMed, Web of Science, and SCOPUS databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. RESULTS: Eleven articles were included. Of the three studies reporting skull base surgery outcomes, greater mean age was correlated with a higher likelihood of transfusion. Pre-admission diagnoses of cardiovascular disease, diabetes, coagulopathy, anticoagulation, liver disease, stroke, and seizure were the most common comorbid diseases of transfused patients. Transfused patients had a greater range of hospital length of stay (15.5-19.9 days versus 4.9-8 days). One study comparing anemic versus non-anemic patients found a marked difference in the mean length of stay (4.6 versus 1.4 days, respectively) between their two patient groups. Additionally, this study found anemic patients to have a 3.4 % mortality rate while the non-anemic cohort had a 0.8 % mortality rate. The average volume of transfused blood in standard and transglabellar/subcranial approaches was 545 mL and 194 mL, respectively. Only one study proposed a hemoglobin threshold specific to skull base surgery for blood transfusion at 7-8 g/dL. CONCLUSION: Based on our scoping review, a hemoglobin level of 7 g/dL (Level B, Class IIa) may represent a reasonable starting point to guide transfusions in skull base surgery, though prospective validation is warranted. |
| DOI | 10.1016/j.jocn.2025.111522 |
| PubMed ID | 40730060 |