Identification of predictive factors for perioperative blood transfusion in colorectal resection patients
- 93 Downloads
Blood transfusion is associated with higher postoperative complication. With the availability of autologous blood and erythropoietin, it would be advantageous to identify patients who are at higher risk for requiring blood transfusion. Our aim is to identify possible predictive factors for perioperative blood transfusion in patients undergoing colorectal resection. We examined 206 patients who underwent colorectal resections.
Materials and methods
We analyzed factors including preoperative hematocrit, age, history of radiation, type of resection, operative blood loss, additional surgical procedure, surgery duration, and comorbidity.
Forty-one patients (19.9%) received perioperative blood transfusion. Twenty patients (55.6%) with preoperative hematocrit less than 30 received transfusion (p < 0.0001). Twenty-one patients (12.4%) with preoperative hematocrit greater than 30 received perioperative blood transfusion. Thirty-three patients (17.9%) under 65 years received transfusion. Eight patients (36.4%) more than the age of 65 received transfusion (p = 0.05). Ten patients (16.1%) without any comorbidity received transfusion, whereas ten patients (15.1%) with one comorbidity, ten patients (22.2%) with two comorbidities, and 11 patients (33.3%) with greater than three comorbidities received blood transfusion (p = 0.07). In the multivariate analysis, relative risk of perioperative blood transfusion was 3.63 for patients with preoperative hematocrit less than 30 (p < 0.0001), 1.26 for patients more than the age of 65 (p = 0.49), and 1.07 for each comorbidity (p = 0.62). Patients with higher number of comorbidities and age greater than 65 tend to have lower preoperative hematocrit than other patients.
Hematocrit less than 30 is an independent risk factor for requiring perioperative blood transfusion, and patients with hematocrit less than 30 should be considered for autologous blood transfusion and erythropoietin.
KeywordsBlood transfusion Colorectal resection Comorbidity Risk factors
- 8.Tang R, Chen HH, Wang YL, Changchien CR, Chen JS, Hsu KC, Chiang JM, Wang JY (2001) Risk factors for surgical site infection after elective resection of the colon and rectum: a single-center prospective study of 2809 consecutive patients. Ann Surg 234(2):181–189CrossRefPubMedPubMedCentralGoogle Scholar
- 11.Donohue JH, Williams S, Cha S, Windschitl HE, Witzig TE, Nelson H, Fitzgibbons RJ, Wieand HS, Moertel CG (1995) Perioperative blood transfusions do not affect disease recurrence of patients undergoing curative resection of colorectal carcinoma: A Mayo/North Central Cancer Treatment Group Study. J Clin Oncol 13:1671–1678CrossRefPubMedGoogle Scholar
- 12.Heiss MM, Mempel W, Delanoff C, Jauch KW, Gabka C, Mempel M, Dieterich HJ, Eissner HJ, Schildberg FW (1994) Blood transfusion-modulated tumor recurrence: first results of a randomized study of autologous versus allogeneic blood transfusion in colorectal cancer surgery. J Clin Oncol 12:1859–1867CrossRefPubMedGoogle Scholar
- 17.Garcia-Erce JA, Cuenca J, Munoz M, Izuel M, Martinez AA, Herrera A, Salano VM, Martinez F (2005) Perioperative stimulation of erythropoiesis with intravenous iron and erythropoietin reduces transfusion requirements in patients with hip fracture. A randomized observational study. Vox Sang 88(4):235–243CrossRefPubMedGoogle Scholar
- 23.Malone D, Kuhls D, Napolitano LM, McCarter R, Scalea T (2000) Blood transfusion in the first 24 hours in associated with systemic inflammatory response syndrome (SIRS) and worse outcome in trauma. Crit Care Med 28(Suppl):A138Google Scholar