| Association between intraoperative blood transfusion and mortality and morbidity in patients undergoing noncardiac surgery. | |
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MedLine Citation:
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PMID: 21239971 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article |
Journal Detail:
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Title: Anesthesiology Volume: 114 ISSN: 1528-1175 ISO Abbreviation: Anesthesiology Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-01-26 Completed Date: 2011-03-03 Revised Date: 2011-10-03 |
Medline Journal Info:
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Nlm Unique ID: 1300217 Medline TA: Anesthesiology Country: United States |
Other Details:
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Languages: eng Pagination: 283-92 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology, University of Rochester School of Medicine, Rochester, New York, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anemia
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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:
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Anesthesiology. 2011 Sep;115(3):660-1
[PMID:
21862895
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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