A comprehensive assessment of transfusion in elective pancreatectomy: risk factors and complications

Raphael C Sun; Anna M Button; Brian J Smith; Richard F Leblond; James R Howe; James J Mezhir

doi:10.1007/s11605-013-2169-6

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A comprehensive assessment of transfusion in elective pancreatectomy: risk factors and complications

Journal article

Open access

Peer reviewed

A comprehensive assessment of transfusion in elective pancreatectomy: risk factors and complications

Raphael C Sun, Anna M Button, Brian J Smith, Richard F Leblond, James R Howe and James J Mezhir

Journal of gastrointestinal surgery, Vol.17(4), pp.627-635

04/2013

DOI: 10.1007/s11605-013-2169-6

PMCID: PMC4388036

PMID: 23423430

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http://doi.org/10.1007/s11605-013-2169-6View

Open Access

Abstract

Specific data are needed regarding the impact of transfusion on operative complications in pancreatectomy. The objectives of this study were to determine risk factors for transfusion and to evaluate the potential association between transfusion and operative complications in elective pancreatectomy procedures. We reviewed our institution's pancreatectomy and ACS-NSQIP databases. Multivariate analysis was used to determine clinicopathologic risk factors predictive of transfusion, and then a transfusion propensity score was developed to evaluate the impact of transfusion on post-pancreatectomy complications. Of the 173 patients who were treated from September 2007 to September 2011, 78 patients (45 %) were transfused ≥ 1 unit of blood (median, 3.0 units; range, 1-55). Risk factors for transfusion included increasing Body Mass Index (BMI), smoking, increasing mortality risk score, preoperative anemia, intraoperative blood loss, and benign pathology. After controlling for these risk factors using a transfusion propensity score, transfusion was an independent predictor of increased complications, infectious complications, and hospital costs. Multiple factors are predictive of transfusion in pancreatectomy, including increasing BMI and smoking. When controlling for transfusion propensity based on these risk factors, RBC transfusion is associated with worse operative outcomes including infectious complications. Development of protocols and strategies to minimize unnecessary transfusion in pancreatectomy are justified.

Postoperative Complications - etiology

Prospective Studies

Humans

Middle Aged

Pancreatectomy

Male

Postoperative Complications - epidemiology

Blood Transfusion - statistics & numerical data

Transfusion Reaction

Young Adult

Aged, 80 and over

Adult

Female

Aged

Elective Surgical Procedures

Details

Title: Subtitle: A comprehensive assessment of transfusion in elective pancreatectomy: risk factors and complications
Creators: Raphael C Sun - Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
Anna M Button
Brian J Smith
Richard F Leblond
James R Howe
James J Mezhir
Resource Type: Journal article
Publication Details: Journal of gastrointestinal surgery, Vol.17(4), pp.627-635
DOI: 10.1007/s11605-013-2169-6
PMID: 23423430
PMCID: PMC4388036
NLM abbreviation: J Gastrointest Surg
ISSN: 1091-255X
eISSN: 1873-4626
Publisher: United States
Grant note: P30 CA086862 / NCI NIH HHS
Language: English
Date published: 04/2013
Academic Unit: Biostatistics; Surgery; Holden Comprehensive Cancer Center; Internal Medicine
Record Identifier: 9983997370802771

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21 Times Cited - Web of Science