Abstract: Objective To analyze the effect of intraoperative blood transfusion on deep venous thrombosis (DVT) of lower limbs in the elderly patients after neurosurgery. Methods The clinical data of 352 elderly patients who underwent neurosurgery in Changhai Hospital from January 2023 to November 2024 were retrospectively analyzed. According to whether intraoperative blood transfusion was performed, the patients were divided into blood transfusion group (82 cases) and non-blood transfusion group (270 cases). The clinical data and the incidence of postoperative DVT were compared between the two groups. In addition, the patients were divided into DVT group (104 cases) and non-DVT group (248 cases) according to whether DVT occurred in the lower limbs after operation. Univariate and multivariate logistic regression analysis was used to analyze the independent risk factors for DVT in the lower limbs. Results There were significant differences in American Society of Aneshesiologists (ASA ) classification and postoperative fibrinogen level between blood transfusion group and non-blood transfusion group (P<0.05). The incidence of DVT in 352 patients was 29.55% (104/352), and the incidence of DVT in blood transfusion group was higher than that in non-blood transfusion group (45.12% vs 24.81%, P<0.001). Multivariate logistic analysis showed that after adjusting age, hypertension, dehydrating agent use, prolonged bed rest, comorbid malignancy, postoperative D-dimer level, the risk of DVT in blood transfusion patients was higher than that in non-blood transfusion patients (OR=2.502, 95%CI: 1.357-4.613, P<0.05). Conclusions Intraoperative blood transfusion is an independent risk factor for postoperative DVT of lower limb in the elderly patients undergoing neurosurgery.

Key words: intraoperative blood transfusion, aged, neurosurgery, deep vein thrombosis, lower limbs