@article{HBSN15171,
author = {Julie Hallet and Alyson L. Mahar and Avery B. Nathens and Melanie E. Tsang and Kaitlyn A. Beyfuss and Yulia Lin and Natalie G. Coburn and Paul J. Karanicolas},
title = {The impact of perioperative blood transfusions on short-term outcomes following hepatectomy},
journal = {Hepatobiliary Surgery and Nutrition},
volume = {7},
number = {1},
year = {2017},
keywords = {},
abstract = {Methods: Using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) registry, we identified all adult patients undergoing elective hepatectomy over 2007–2012. Two exposure groups were created based on RBCT. Primary outcomes were 30-day major morbidity and mortality. Secondary outcomes included 30-day system-specific morbidity and length of stay (LOS). Relative risks (RR) with 95% confidence interval (95% CI) were computed using regression analyses. Sensitivity analyses were conducted to understand how missing data might have impacted the results.
Results: A total of 12,180 patients were identified. Of those, 11,712 met inclusion criteria, 2,951 (25.2%) of whom received RBCT. Major morbidity occurred in 14.9% of patients and was strongly associated with RBCT (25.3% vs. 11.3%; P<0.001). Transfused patients had higher rates of 30-day mortality (5.6% vs. 1.0%; P<0.0001). After adjustment for baseline and clinical characteristics, RBCT was independently associated with increased major morbidity (RR 1.80; 95% CI: 1.61–1.99), mortality (RR 3.62; 95% CI: 2.68–4.89), and 1.29 times greater LOS (RR 1.29; 95% CI: 1.25–1.32). Results were robust to a number of sensitivity analyses for missing data.
Conclusions: Perioperative RBCT for hepatectomy was independently associated with worse short-term outcomes and prolonged LOS. These findings further the rationale to focus on minimizing RBCT for hepatectomy, when they can be avoided.},
issn = {2304-389X}, url = {https://hbsn.amegroups.org/article/view/15171}
}