Blood transfusion guidelines in skull base surgery: a scoping review.

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.

• Publication year

  2025

• Venue

  Journal of clinical neuroscience

• Publication date

  2025-07-28

• Fields of study

  Medicine

• Identifiers
  DOI 10.1016/j.jocn.2025.111522PMID 40730060
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

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