Factors Influencing Perioperative Blood Transfusions in Patients with Gastrointestinal Cancer

Varun Verma, Roderich E. Schwarz

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)97-104
Number of pages8
JournalJournal of Surgical Research
Volume141
Issue number1
DOIs
StatePublished - Jul 2007

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Gastrointestinal Neoplasms
Erythropoietin
Blood Transfusion
Serum
Morbidity
Mortality
Neoplasms

Keywords

  • bold transfusions
  • gastrectomy
  • gastrointestinal cancer
  • liver resection
  • pancreatectomy

ASJC Scopus subject areas

  • Surgery

Cite this

Factors Influencing Perioperative Blood Transfusions in Patients with Gastrointestinal Cancer. / Verma, Varun; Schwarz, Roderich E.

In: Journal of Surgical Research, Vol. 141, No. 1, 07.2007, p. 97-104.

Research output: Contribution to journalArticle

Verma, Varun ; Schwarz, Roderich E. / Factors Influencing Perioperative Blood Transfusions in Patients with Gastrointestinal Cancer. In: Journal of Surgical Research. 2007 ; Vol. 141, No. 1. pp. 97-104.
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abstract = "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.",
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