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Transfusion practice and complications after laparotomy - an observational analysis of a randomized clinical trial.
MedLine Citation:
PMID:  22775347     Owner:  NLM     Status:  Publisher    
Background  Transfusion of allogeneic red blood cells (RBC) may be associated with side effects. This study aimed to assess whether an association could be detected between transfusion practice and the occurrence of complications after laparotomy. Study design and methods  This study is an observational analysis of data from a randomized trial in 1400 patients who underwent laparotomy. A subgroup of 224 transfused patients with an intraoperative blood loss ≥200 ml were included in the analysis. Logistic regression analysis was used to investigate risk factors for postoperative complications. The ratio of intraoperative RBC transfusion to blood loss was computed, and patients grouped by the median into a liberal transfusion practice (ratio equal to or above the median) and a restrictive transfusion practice group (ratio below the median). Results  Surgical site infection occurred in 27% of patients in the liberal group vs. 20% of patients in the restrictive group with an OR of 1·5 [95% CI: 0·8-2·9] (P = 0·18) and an OR of 1·2 [95% CI: 0·5-2·9] (P = 0·73) when adjusting for known confounding variables. Pneumonia occurred in 14% vs. 8% in the liberal and restrictive group, respectively (adjusted P = 0·07), and admission to the intensive care unit was 15% vs. 7%, respectively (adjusted P = 0·02), but no other significant differences were found. Conclusion  A liberal transfusion practice was not significantly associated with postoperative complications, but pneumonia tended to be more common in the liberal group, which was more often admitted to the intensive care unit.
K Nielsen; C S Meyhoff; P I Johansson; L N Jorgensen; L S Rasmussen;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-9
Journal Detail:
Title:  Vox sanguinis     Volume:  -     ISSN:  1423-0410     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0413606     Medline TA:  Vox Sang     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Author(s). Vox Sanguinis © 2012 International Society of Blood Transfusion.
Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark Section for Transfusion Medicine, Capital Region Blood Bank, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark Department of Surgery, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
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