TY - JOUR
T1 - Factors Influencing Perioperative Blood Transfusions in Patients with Gastrointestinal Cancer
AU - Verma, Varun
AU - Schwarz, Roderich E.
PY - 2007/7
Y1 - 2007/7
N2 - Background: Patients undergoing major cancer resections often receive blood transfusions (TFs). Preoperative erythropoietin (EPO) offers the rationale to reduce TFs and related morbidity. Methods: Perioperative TF information was collected prospectively in a single surgeon practice over 5 years. Results: Three hundred forty-four patients underwent a major procedure, including pancreatic (n = 130, 38%), hepatobiliary (n = 87, 25%), gastroesophageal (n = 69, 20%), and other operations (n = 58, 17%). Median estimated blood loss (EBL) was 375 mL. PRBC TFs were given in 83 cases (24%), at a median of 2 units [1-16]. TF frequency and EBL did not differ between diagnoses. Multivariate TF associations existed for Hgb (P < 0.0001, OR 0.335), EBL (P < 0.0001, OR 1.007), serum Cl (P = 0.004, OR 1.25), serum Na (P = 0.02, OR 0.810), and age (P = 0.04, OR 1.033). TFs (versus no TFs) were linked to major complications (43 versus 20%, P = 0.0002), mortality (12% versus 3%, P = 0.001), and increased LOS (9 versus 7 days, P < 0.0001). A potential benefit for preoperative EPO to avoid TFs could be derived for only 31 patients (9%). Conclusions: In this low TF rate of 24% for major visceral resections, few preoperative parameters are able to identify subgroups at risk for TFs aside from blood counts. Our data would not support generalized preoperative EPO administration.
AB - Background: Patients undergoing major cancer resections often receive blood transfusions (TFs). Preoperative erythropoietin (EPO) offers the rationale to reduce TFs and related morbidity. Methods: Perioperative TF information was collected prospectively in a single surgeon practice over 5 years. Results: Three hundred forty-four patients underwent a major procedure, including pancreatic (n = 130, 38%), hepatobiliary (n = 87, 25%), gastroesophageal (n = 69, 20%), and other operations (n = 58, 17%). Median estimated blood loss (EBL) was 375 mL. PRBC TFs were given in 83 cases (24%), at a median of 2 units [1-16]. TF frequency and EBL did not differ between diagnoses. Multivariate TF associations existed for Hgb (P < 0.0001, OR 0.335), EBL (P < 0.0001, OR 1.007), serum Cl (P = 0.004, OR 1.25), serum Na (P = 0.02, OR 0.810), and age (P = 0.04, OR 1.033). TFs (versus no TFs) were linked to major complications (43 versus 20%, P = 0.0002), mortality (12% versus 3%, P = 0.001), and increased LOS (9 versus 7 days, P < 0.0001). A potential benefit for preoperative EPO to avoid TFs could be derived for only 31 patients (9%). Conclusions: In this low TF rate of 24% for major visceral resections, few preoperative parameters are able to identify subgroups at risk for TFs aside from blood counts. Our data would not support generalized preoperative EPO administration.
KW - bold transfusions
KW - gastrectomy
KW - gastrointestinal cancer
KW - liver resection
KW - pancreatectomy
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U2 - 10.1016/j.jss.2007.03.032
DO - 10.1016/j.jss.2007.03.032
M3 - Article
C2 - 17574043
AN - SCOPUS:34250157398
SN - 0022-4804
VL - 141
SP - 97
EP - 104
JO - Journal of Surgical Research
JF - Journal of Surgical Research
IS - 1
ER -