Peri-operative transfusion risk in classic bladder exstrophy closure: Results from a national database review

A significant number of patients undergoing CBE closure required transfusion in the peri-operative period (57.7%). Patient characteristics found to have a higher rate of transfusion included osteotomy, external fixation, increased operative times, and longer post-operative LOS. In children undergoing closure for CBE, a large number require transfusion. The rate of transfusion is greater in older children and children undergoing osteotomy. Although osteotomy has a potentially important clinical role, especially in older patients, this study emphasizes the need for proper family counseling to include the increased likelihood of a blood transfusion and the risks associated with blood transfusion if osteotomies are performed.Table. Patient characteristics and outcomes of patients undergoing closure for CBE requiring peri-operative transfusion and those not requiring transfusion.TransfusionNo transfusionp-valuen%n%Total4533Neonate920.01545.50.016Age (days)a20035-55784-3820.050Age >3 days4293.32575.80.046Female2248.91648.50.972Male2351.11751.5Caucasian3577.82163.60.170Non-Caucasian1022.21236.4Osteotomy3782.21648.50.002External fixation2146.726.1<0.001Total operation time (minutes)a447373-534295238-371<0.001Post-operative length of stay (days)a3515-50176-310.003Post-operative complication2555.61648.50.536Bold p-values indicate a significant result at p < 0.05.aValues are expressed as median (interquartile range).