Impact of perioperative transfusion in patients undergoing resection of colorectal cancer liver metastases: A population-based study.

Bo Long, Zhen-Nan Xiao, Li-Hua Shang, Bo-Yan Pan, Jun Chai
Author Information
  1. Bo Long: Department of Anesthesiology, Shengjing Hospital, China Medical University, Shenyang 110004, Liaoning Province, China.
  2. Zhen-Nan Xiao: Department of Anesthesiology, Shengjing Hospital, China Medical University, Shenyang 110004, Liaoning Province, China.
  3. Li-Hua Shang: Department of Anesthesiology, Shengjing Hospital, China Medical University, Shenyang 110004, Liaoning Province, China.
  4. Bo-Yan Pan: Department of Anesthesiology, Shengjing Hospital, China Medical University, Shenyang 110004, Liaoning Province, China.
  5. Jun Chai: Department of Anesthesiology, Shengjing Hospital, China Medical University, Shenyang 110004, Liaoning Province, China. chaij@sj-hospital.org.

Abstract

BACKGROUND: Perioperative allogeneic blood transfusion is associated with poorer outcomes.
AIM: To identify the factors that were associated with perioperative transfusion and to examine the impact of perioperative transfusion in patients undergoing resection of colorectal cancer (CRC) liver metastases.
METHODS: The United States National Inpatient Sample (NIS) database was searched for patients with CRC who received surgery for liver metastasis. Linear and logistic regression analyses were performed.
RESULTS: A total of 2018 patients were included, and 480 had a perioperative transfusion. Emergency admission (adjusted odds ratio [aOR] = 1.42; 95%CI: 1.07-1.87), hepatic lobectomy (aOR = 1.76; 95%CI: 1.42-2.19), and chronic anemia (aOR = 2.62; 95%CI: 2.04-3.35) were associated with increased chances of receiving a transfusion, but receiving surgery at a teaching hospital (aOR = 0.75; 95%CI: 0.58-0.98) was associated with a decreased chance of receiving a transfusion. Receiving a perioperative transfusion was significantly associated with increased in-hospital mortality (aOR = 3.38; 95%CI: 1.57-7.25), and increased overall postoperative complications (aOR = 1.67; 95%CI: 1.31-2.13), as well as longer length of hospital stay.
CONCLUSION: Patients with an emergency admission, hepatic lobectomy, chronic anemia, and who have surgery at a non-teaching hospital are more likely to receive a perioperative transfusion. Patients with CRC undergoing surgery for hepatic metastases who receive a perioperative transfusion are at a higher risk of in-hospital mortality, postoperative complications, and longer length of hospital stay.

Keywords

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Word Cloud

Created with Highcharts 10.0.0transfusionperioperative1=95%CI:associatedaORpatientssurgeryhospitalbloodundergoingcancerCRCliverhepaticincreasedreceivingPerioperativeresectioncolorectalmetastasesNationalmetastasisadmissionlobectomychronicanemia20in-hospitalmortalitypostoperativecomplicationslongerlengthstayPatientsreceiveBACKGROUND:allogeneicpooreroutcomesAIM:identifyfactorsexamineimpactMETHODS:UnitedStatesInpatientSampleNISdatabasesearchedreceivedLinearlogisticregressionanalysesperformedRESULTS:total2018included480Emergencyadjustedoddsratio[aOR]4207-1877642-2196204-335chancesteaching7558-098decreasedchanceReceivingsignificantly33857-725overall6731-213wellCONCLUSION:emergencynon-teachinglikelyhigherriskImpactmetastases:population-basedstudyColorectalIntraoperativelossLiverinpatientsample

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