Document Detail


Association between intraoperative blood transfusion and mortality and morbidity in patients undergoing noncardiac surgery.
MedLine Citation:
PMID:  21239971     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The impact of intraoperative erythrocyte transfusion on outcomes of anemic patients undergoing noncardiac surgery has not been well characterized. The objective of this study was to examine the association between blood transfusion and mortality and morbidity in patients with severe anemia (hematocrit less than 30%) who are exposed to one or two units of erythrocytes intraoperatively.
METHODS: This was a retrospective analysis of the association of blood transfusion and 30-day mortality and 30-day morbidity in 10,100 patients undergoing general, vascular, or orthopedic surgery. We estimated separate multivariate logistic regression models for 30-day mortality and for 30-day complications.
RESULTS: Intraoperative blood transfusion was associated with an increased risk of death (odds ratio [OR], 1.29; 95% CI, 1.03-1.62). Patients receiving an intraoperative transfusion were more likely to have pulmonary, septic, wound, or thromboembolic complications, compared with patients not receiving an intraoperative transfusion. Compared with patients who were not transfused, patients receiving one or two units of erythrocytes were more likely to have pulmonary complications (OR, 1.76; 95% CI, 1.48-2.09), sepsis (OR, 1.43; 95% CI, 1.21-1.68), thromboembolic complications (OR, 1.77; 95% CI, 1.32-2.38), and wound complications (OR, 1.87; 95% CI, 1.47-2.37).
CONCLUSIONS: Intraoperative blood transfusion is associated with a higher risk of mortality and morbidity in surgical patients with severe anemia. It is unknown whether this association is due to the adverse effects of blood transfusion or is, instead, the result of increased blood loss in the patients receiving blood.
Authors:
Laurent G Glance; Andrew W Dick; Dana B Mukamel; Fergal J Fleming; Raymond A Zollo; Richard Wissler; Rabih Salloum; U Wayne Meredith; Turner M Osler
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anesthesiology     Volume:  114     ISSN:  1528-1175     ISO Abbreviation:  Anesthesiology     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-26     Completed Date:  2011-03-03     Revised Date:  2011-10-03    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  283-92     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, University of Rochester School of Medicine, Rochester, New York, USA.
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MeSH Terms
Descriptor/Qualifier:
Anemia / epidemiology*,  therapy*
Causality
Erythrocyte Transfusion / methods,  mortality*,  statistics & numerical data*
Female
Follow-Up Studies
Humans
Intraoperative Care / methods*
Lung Diseases / epidemiology
Male
Middle Aged
Odds Ratio
Postoperative Complications / epidemiology*
Retrospective Studies
Risk Factors
Surgical Procedures, Operative*
Survival Analysis
Survival Rate
Treatment Outcome
Comments/Corrections
Comment In:
Anesthesiology. 2011 Sep;115(3):660-1   [PMID:  21862895 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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