| Operative blood loss, blood transfusion, and 30-day mortality in older patients after major noncardiac surgery. | |
| | |
MedLine Citation:
|
PMID: 20505504 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: Anemia and operative blood loss are common in the elderly, but evidence is lacking on whether intraoperative blood transfusions can reduce the risk of postoperative death. METHODS: We analyzed retrospective data from 239,286 patients 65 years of older who underwent major noncardiac surgery in 1997 to 2004 at veteran hospitals nationwide. Propensity-score matching was used to adjust for differences between patients who received intraoperative blood transfusions (9.4%) and those who did not, and data were used to determine the association between intraoperative blood transfusion and 30-day postoperative mortality. RESULTS: After propensity-score matching, intraoperative blood transfusion was associated with mortality risk reductions in patients with preoperative hematocrit levels of <24% (odds ratio: 0.60, 95% CI: 0.41-0.87), and in patients with hematocrit of 30% or greater when there is substantial (500-999 mL) blood loss (odds ratio: 0.35, 95% CI: 0.22-0.56 for hematocrit levels between 30%-35.9% and 0.78, 95% CI: 0.62-0.97 for hematocrit levels of 36% or greater). When operative blood loss was <500 mL, transfusion was not associated with mortality reductions for patients with hematocrit levels of 24% or greater, and conferred increased mortality risks in patients with preoperative hematocrit levels between 30% to 35.9% (odds ratio 1.29, 95% CI: 1.04-1.60). CONCLUSIONS: Intraoperative blood transfusion is associated with a lower 30-day postoperative mortality among elderly patients undergoing major noncardiac surgery if there is substantial operative blood loss or low preoperative hematocrit levels (<24%). Transfusion is associated with increased mortality risks for those with preoperative hematocrit levels between 30% and 35.9% and <500 mL of blood loss. |
| | |
Authors:
|
Wen-Chih Wu; Tracy S Smith; William G Henderson; Charles B Eaton; Roy M Poses; Georgette Uttley; Vincent Mor; Satish C Sharma; Michael Vezeridis; Shukri F Khuri; Peter D Friedmann |
Related Documents
:
|
7051464 - Blood transfusion and kidney transplantation: effect of small doses of blood on kidney ... 3148374 - Incidence of rh anti-e and anti-c production among japanese after blood transfusion. 8370294 - Effects of blood transfusion on oxygen transport variables in severe sepsis. 8740354 - Factors influencing haemostasis and blood transfusion in cardiac surgery. 22216364 - Individuals with le(a+b-) blood group have increased susceptibility to symptomatic vibr... 11492954 - Lactate release, concentration in blood, and apparent distribution volume after intense... |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S. |
Journal Detail:
|
Title: Annals of surgery Volume: 252 ISSN: 1528-1140 ISO Abbreviation: Ann. Surg. Publication Date: 2010 Jul |
Date Detail:
|
Created Date: 2010-06-23 Completed Date: 2010-07-12 Revised Date: 2010-12-10 |
Medline Journal Info:
|
Nlm Unique ID: 0372354 Medline TA: Ann Surg Country: United States |
Other Details:
|
Languages: eng Pagination: 11-7 Citation Subset: AIM; IM |
Affiliation:
|
Department of Community Health, Brown University, Providence Veterans Affairs Medical Center, Providence, RI, USA. Wen-Chih.Wu@va.gov |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Blood Loss, Surgical* / mortality Blood Transfusion* Female Hematocrit Humans Intraoperative Care* Male Postoperative Complications / mortality Postoperative Period Streptonigrin Surgical Procedures, Operative / mortality* |
| Chemical | |
Reg. No./Substance:
|
0/retrostatin; 3930-19-6/Streptonigrin |
| Comments/Corrections | |
Comment In:
|
Evid Based Med. 2010 Dec;15(6):185-6
[PMID:
20861407
]
Ann Surg. 2010 Jul;252(1):18-9 [PMID: 20562604 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Mammary-type Tubulolobular Carcinoma of Anogenital Mammary-like Glands With Prominent Stromal Elasto...
Next Document: Prognostic Impact of Regional Lymph Node Micrometastasis in Patients With Node-Negative Biliary Canc...