Retrospective Cohort Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2019; 7(10): 1093-1102
Published online May 26, 2019. doi: 10.12998/wjcc.v7.i10.1093
Impact of perioperative transfusion in patients undergoing resection of colorectal cancer liver metastases: A population-based study
Bo Long, Zhen-Nan Xiao, Li-Hua Shang, Bo-Yan Pan, Jun Chai
Bo Long, Zhen-Nan Xiao, Li-Hua Shang, Bo-Yan Pan, Jun Chai, Department of Anesthesiology, Shengjing Hospital, China Medical University, Shenyang 110004, Liaoning Province, China
Bo-Yan Pan, Department of Anesthesiology, Shenyang Women’s and Children’s Hospital, Shenyang 110011, Liaoning Province, China
Author contributions: Long B conceptualized and designed the study, analyzed and interpreted the data, drafted the manuscript, and approved the final manuscript; Xiao ZN acquired the data, drafted the manuscript, and approved the manuscript; Shang LH collected the data, performed statistical analysis, and approved the manuscript; Pan BY acquired the data, guaranteed the integrity of the entire study, revised the study, and approved the final manuscript; Chai J conceptualized and designed the study, analyzed and interpreted the data, and approved the final manuscript.
Conflict-of-interest statement: The authors disclose no conflicts of interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jun Chai, MD, PhD, Department of Anesthesiology, Shengjing Hospital, China Medical University, No. 36, Sanhao Street, Shenyang 110004, Liaoning Province, China. chaij@sj-hospital.org
Telephone: +86-24-23892617 Fax: +86-24-23892617
Received: February 3, 2019
Peer-review started: February 6, 2019
First decision: March 5, 2019
Revised: March 24, 2019
Accepted: May 1, 2019
Article in press: May 1, 2019
Published online: May 26, 2019
Processing time: 113 Days and 2.1 Hours
Abstract
BACKGROUND

Perioperative allogeneic blood transfusion is associated with poorer outcomes.

AIM

To identify the factors that were associated with perioperative transfusion and to examine the impact of perioperative transfusion in patients undergoing resection of colorectal cancer (CRC) liver metastases.

METHODS

The United States National Inpatient Sample (NIS) database was searched for patients with CRC who received surgery for liver metastasis. Linear and logistic regression analyses were performed.

RESULTS

A total of 2018 patients were included, and 480 had a perioperative transfusion. Emergency admission (adjusted odds ratio [aOR] = 1.42; 95%CI: 1.07-1.87), hepatic lobectomy (aOR = 1.76; 95%CI: 1.42-2.19), and chronic anemia (aOR = 2.62; 95%CI: 2.04-3.35) were associated with increased chances of receiving a transfusion, but receiving surgery at a teaching hospital (aOR = 0.75; 95%CI: 0.58-0.98) was associated with a decreased chance of receiving a transfusion. Receiving a perioperative transfusion was significantly associated with increased in-hospital mortality (aOR = 3.38; 95%CI: 1.57-7.25), and increased overall postoperative complications (aOR = 1.67; 95%CI: 1.31-2.13), as well as longer length of hospital stay

CONCLUSION

Patients with an emergency admission, hepatic lobectomy, chronic anemia, and who have surgery at a non-teaching hospital are more likely to receive a perioperative transfusion. Patients with CRC undergoing surgery for hepatic metastases who receive a perioperative transfusion are at a higher risk of in-hospital mortality, postoperative complications, and longer length of hospital stay.

Keywords: Colorectal cancer; Liver metastasis; Perioperative blood transfusion; Intraoperative blood loss; National inpatient sample

Core tip: Among patients undergoing resection of colorectal cancer liver metastases, those with an emergency admission, hepatic lobectomy, chronic anemia, and undergoing surgery at a non-teaching hospital are more likely to receive a perioperative transfusion. Furthermore, patients who receive a perioperative transfusion are at a higher risk of in-hospital mortality, postoperative complications, and longer length of hospital stay.