Blood transfusion and cancer surgery outcomes: A continued reason for concern

The adverse effects of blood transfusion after cancer surgery have been recently challenged in older anemic persons or those with substantial intraoperative blood loss. We hypothesized that intraoperative blood transfusions continue to adversely impact short-term cancer surgery outcomes regardless o...

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Vydané v:Surgery Ročník 152; číslo 3; s. 344 - 354
Hlavní autori: Al-Refaie, Waddah B., Parsons, Helen M., Markin, Abraham, Abrams, Jerome, Habermann, Elizabeth B.
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: New York, NY Mosby, Inc 01.09.2012
Elsevier
Predmet:
Aged
Biological and medical sciences
Blood Loss, Surgical - prevention & control
Blood Transfusion - statistics & numerical data
Erythrocyte Transfusion - adverse effects
Erythrocyte Transfusion - statistics & numerical data
Female
General aspects
Humans
Incidence
Intraoperative Period
Length of Stay
Male
Medical sciences
Middle Aged
Multivariate Analysis
Neoplasms - surgery
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Risk Factors
Surgery
Survival Rate
Transfusion Reaction
Treatment Outcome
Medicine
Prognosis
Treatment
Transfusion
Surgery
Evolution
Malignant tumor
Blood
Cancer
ISSN:0039-6060, 1532-7361, 1532-7361
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Shrnutí:The adverse effects of blood transfusion after cancer surgery have been recently challenged in older anemic persons or those with substantial intraoperative blood loss. We hypothesized that intraoperative blood transfusions continue to adversely impact short-term cancer surgery outcomes regardless of age or preoperative hematocrit levels. Using the 2005 to 2008 American College of Surgeons National Surgical Quality Improvement Program, we identified 38,926 patients who underwent cancer surgery. Pre-, intra-, and postoperative factors were compared by units of blood transfusion a patient received. Stratified multivariable analyses, by age and hematocrit level, were performed to assess the impact of blood transfusion on operative outcomes, adjusting for covariates. Fourteen percent of patients received an intraoperative blood transfusion. Of those, >60% received only 1 to 2 units of blood. Receipt of intraoperative blood transfusion was associated with higher rates of 30-day operative mortality, major complications, total number of complications, and prolonged length of stay across age groups and in persons with low to normal hematocrit levels. The present study shows that intraoperative blood transfusion adversely impacts short-term operative cancer surgery outcomes across all age groups and in those with low to normal hematocrit levels. These findings provide insightful implications on the patterns of blood transfusion during cancer surgery that deserve further investigation.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:0039-6060
1532-7361
1532-7361
DOI:10.1016/j.surg.2012.06.008