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A Comprehensive Assessment of Transfusion in Elective Pancreatectomy: Risk Factors and Complications

  • 2012 SSAT Poster Presentation
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

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.

Study Design

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.

Results

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.

Conclusions

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.

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Abbreviations

RBC:

Red blood cell

ACS-NSQIP:

American College of Surgeons National Surgical Quality Improvement Program

CT:

Computed tomography

ASA:

American Society of Anesthesiology

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Acknowledgments

The authors wish to thank Mary Belding-Schmidt for excellent construction and maintenance of our department’s ACS-NSQIP database. We also thank Mary Kay Brooks for her dedication and hard work to construct and maintain our institution’s pancreatectomy and transfusion databases. The authors dedicate this work to pancreatic cancer patients and their families.

Disclosures

The authors have no conflict of interest

Author information

Authors and Affiliations

  1. Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA

    Raphael C. Sun, James R. Howe & James J. Mezhir

  2. Epidemiology and Biostatistics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA

    Anna M. Button & Brian J. Smith

  3. Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA

    Richard F. Leblond

  4. Division of Surgical Oncology and Endocrine Surgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive; 4642 JCP, Iowa City, IA, 52242, USA

    James J. Mezhir

Authors
  1. Raphael C. Sun
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  2. Anna M. Button
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  3. Brian J. Smith
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  4. Richard F. Leblond
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  5. James R. Howe
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  6. James J. Mezhir
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Corresponding author

Correspondence to James J. Mezhir.

Additional information

This paper was presented in part at the Society for Surgery of the Alimentary Tract 53rd annual meeting May 2012, San Diego, California.

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Sun, R.C., Button, A.M., Smith, B.J. et al. A Comprehensive Assessment of Transfusion in Elective Pancreatectomy: Risk Factors and Complications. J Gastrointest Surg 17, 627–635 (2013). https://doi.org/10.1007/s11605-013-2169-6

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  • DOI: https://doi.org/10.1007/s11605-013-2169-6

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