E-ISSN: 1019-5157
ISSN: 2651-5024
Research
ABO Blood Group, High-Sensitivity C-Reactive Protein, and Bone Resorption After Autologous Calvarial Bone Grafting: A Retrospective Study
Haopeng Li ,
Liang Liu✉ ,
Gang Wei ,
Chenshu He ,
Xingyu Wang ,
Xingyu Qiu
Department of Neurosurgery, He Affiliated Hospital Of Southwest Medical University; Department of Neurosurgery, The Affiliated Hospital Of Southwest Medical University; Department of Neurosurgery, Naxi District People's Hospital; southwest medical university, southwest medical university
Accepted: 26/10/2026
Article in Press
Corresponding Author:
Liang Liu (liulst@163.com)
Abstract
Aim
Bone resorption is a common complication after autologous cranioplasty. Whether the ABO blood group influences this risk, and how it relates to inflammation have yet to be ascertained. This study examined the associations between ABO blood group, high-sensitivity C-reactive protein (hsCRP) levels, and bone resorption after autologous calvarial bone grafting.
Material and Methods
This retrospective study included 91 patients who underwent autologous skull outer table grafting between September 2020 and October 2025. Bone resorption was defined as a graft volume reduction of ≥10% on computed tomography 3, 6, or 12 months postoperatively. Patients were grouped by ABO type and compared as non-O (A + B + AB) versus O. There was hsCRP data available for 57 of the patients. This was measured on postoperative day 3 and at subsequent follow-up visits. Univariable comparisons were performed using χ² or Fisher’s exact tests. Due to the small sample size and multiple subgroup comparisons, all subgroup analyses were exploratory.
Results
Bone resorption occurred in 21 of the 91 (23.1%) patients. The observed proportions by blood type were: A, 4/29 (13.8%); B, 8/25 (32.0%); AB, 4/10 (40.0%); and O, 5/27 (18.5%). Of these, only the difference between AB and A was statistically significant (p=0.024). Non-O versus O was 16/64 (25.0%) versus 5/27 (18.5%) (p=0.071). Elevated hsCRP was significantly more common in the bone resorption group (15/17, 88.23% vs 28/40, 70.0%; p=0.032). hsCRP patterns differed between blood groups, these findings exploratory.
Conclusion
In this retrospective cohort, ABO blood group was associated with bone resorption after autologous calvarial bone grafting. The highest observed proportion of bone resorption was seen in type AB and the lowest in type A. Elevated postoperative hsCRP was also associated with bone resorption. These findings require validation in larger prospective studies, with adjustment for confounders before blood-type-based risk stratification can be recommended for use in clinical practice.
Bone resorption is a common complication after autologous cranioplasty. Whether the ABO blood group influences this risk, and how it relates to inflammation have yet to be ascertained. This study examined the associations between ABO blood group, high-sensitivity C-reactive protein (hsCRP) levels, and bone resorption after autologous calvarial bone grafting.
Material and Methods
This retrospective study included 91 patients who underwent autologous skull outer table grafting between September 2020 and October 2025. Bone resorption was defined as a graft volume reduction of ≥10% on computed tomography 3, 6, or 12 months postoperatively. Patients were grouped by ABO type and compared as non-O (A + B + AB) versus O. There was hsCRP data available for 57 of the patients. This was measured on postoperative day 3 and at subsequent follow-up visits. Univariable comparisons were performed using χ² or Fisher’s exact tests. Due to the small sample size and multiple subgroup comparisons, all subgroup analyses were exploratory.
Results
Bone resorption occurred in 21 of the 91 (23.1%) patients. The observed proportions by blood type were: A, 4/29 (13.8%); B, 8/25 (32.0%); AB, 4/10 (40.0%); and O, 5/27 (18.5%). Of these, only the difference between AB and A was statistically significant (p=0.024). Non-O versus O was 16/64 (25.0%) versus 5/27 (18.5%) (p=0.071). Elevated hsCRP was significantly more common in the bone resorption group (15/17, 88.23% vs 28/40, 70.0%; p=0.032). hsCRP patterns differed between blood groups, these findings exploratory.
Conclusion
In this retrospective cohort, ABO blood group was associated with bone resorption after autologous calvarial bone grafting. The highest observed proportion of bone resorption was seen in type AB and the lowest in type A. Elevated postoperative hsCRP was also associated with bone resorption. These findings require validation in larger prospective studies, with adjustment for confounders before blood-type-based risk stratification can be recommended for use in clinical practice.
Keywords
ABO blood group
Autologous bone grafting
Bone resorption
C-reactive protein
Retrospective study