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Multicenter Study
. 2018 Sep;216(3):487-491.
doi: 10.1016/j.amjsurg.2018.02.015. Epub 2018 Feb 17.

The negative effect of perioperative red blood cell transfusion on morbidity and mortality after major abdominal operations

Nathan R Elwood  1 , Allison N Martin  1 , Florence E Turrentine  2 , R Scott Jones  2 , Victor M Zaydfudim  3
Affiliations
Multicenter Study

The negative effect of perioperative red blood cell transfusion on morbidity and mortality after major abdominal operations

Nathan R Elwood et al. Am J Surg. 2018 Sep.

Abstract

Background: This study aims to test associations between perioperative blood transfusion and postoperative morbidity and mortality after major abdominal operations.

Methods: The 2014 ACS NSQIP dataset was queried for all patients who underwent one of the ten major abdominal operations. Separate multivariable regression models, were developed to evaluate the independent effects of perioperative blood transfusion on morbidity and mortality.

Results: Of 48,854 patients in the study cohort, 4887 (10%) received a blood transfusion. Rates of transfusion ranged from 4% for laparoscopic gastrointestinal resection to 58% for open AAA. After adjusting for significant effects of NSQIP-estimated probabilities, transfusion was independently associated with morbidity and mortality after open AAA repair (OR = 1.99/14.4 respectively, p ≤ 0.010), esophagectomy (OR = 2.80/3.0, p < 0.001), pancreatectomy (OR = 1.88/3.01, p < 0.001), hepatectomy (OR = 2.82/5.78, p < 0.001), colectomy (OR = 2.15/3.17, p < 0.001), small bowel resection (OR = 2.81/3.83, p ≤ 0.004), and laparoscopic gastrointestinal operations (OR = 2.73/4.05, p < 0.001).

Conclusions: Perioperative blood transfusion is independently associated with an increased risk of morbidity and mortality after most major abdominal operations.

Keywords: Abdominal surgery; Blood transfusion; Morbidity; Mortality; Surgical outcomes.

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Conflict of interest statement

Disclosures: The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Distribution of patient specific intra-abdominal operations included in the study (n=48,854)
Figure 2
Figure 2
Proportion of patients who had red blood cell transfusion for each operation
See this image and copyright information in PMC

Comment in

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