Association between Intraoperative Blood Transfusion and Mortality and Morbidity in Patients Undergoing Noncardiac Surgery
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 (hematocr...
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| Veröffentlicht in: | Anesthesiology (Philadelphia) 2011-02, Vol.114 (2), p.283-292 |
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| creator | GLANCE, Laurent G DICK, Andrew W MUKAMEL, Dana B FLEMING, Fergal J ZOLLO, Raymond A WISSLER, Richard SALLOUM, Rabih MEREDITH, U. Wayne OSLER, Turner M |
| description | 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.
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.
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).
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. |
| doi_str_mv | 10.1097/aln.0b013e3182054d06 |
| format | Article |
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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.
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).
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.</description><identifier>ISSN: 0003-3022</identifier><identifier>EISSN: 1528-1175</identifier><identifier>DOI: 10.1097/aln.0b013e3182054d06</identifier><identifier>PMID: 21239971</identifier><identifier>CODEN: ANESAV</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Anemia - epidemiology ; Anemia - therapy ; Anesthesia ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Causality ; Erythrocyte Transfusion - methods ; Erythrocyte Transfusion - mortality ; Erythrocyte Transfusion - statistics & numerical data ; Female ; Follow-Up Studies ; Humans ; Intraoperative Care - methods ; Lung Diseases - epidemiology ; Male ; Medical sciences ; Middle Aged ; Odds Ratio ; Postoperative Complications - epidemiology ; Retrospective Studies ; Risk Factors ; Surgical Procedures, Operative ; Survival Analysis ; Survival Rate ; Treatment Outcome</subject><ispartof>Anesthesiology (Philadelphia), 2011-02, Vol.114 (2), p.283-292</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c448t-f6b1985d04d222d222e36b42b074e5015d9fa475b105428d25df61b2ee6ddebf3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23830073$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21239971$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>GLANCE, Laurent G</creatorcontrib><creatorcontrib>DICK, Andrew W</creatorcontrib><creatorcontrib>MUKAMEL, Dana B</creatorcontrib><creatorcontrib>FLEMING, Fergal J</creatorcontrib><creatorcontrib>ZOLLO, Raymond A</creatorcontrib><creatorcontrib>WISSLER, Richard</creatorcontrib><creatorcontrib>SALLOUM, Rabih</creatorcontrib><creatorcontrib>MEREDITH, U. Wayne</creatorcontrib><creatorcontrib>OSLER, Turner M</creatorcontrib><title>Association between Intraoperative Blood Transfusion and Mortality and Morbidity in Patients Undergoing Noncardiac Surgery</title><title>Anesthesiology (Philadelphia)</title><addtitle>Anesthesiology</addtitle><description>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.
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.
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).
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.</description><subject>Anemia - epidemiology</subject><subject>Anemia - therapy</subject><subject>Anesthesia</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Causality</subject><subject>Erythrocyte Transfusion - methods</subject><subject>Erythrocyte Transfusion - mortality</subject><subject>Erythrocyte Transfusion - statistics & numerical data</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Intraoperative Care - methods</subject><subject>Lung Diseases - epidemiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Odds Ratio</subject><subject>Postoperative Complications - epidemiology</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Surgical Procedures, Operative</subject><subject>Survival Analysis</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>0003-3022</issn><issn>1528-1175</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkctKAzEUhoMoWqtvIJKNuJqay2Quy1q8Qb2AdT0kkzMlMk1qMqPUpzelrYKLEP7w_efAF4TOKBlRUuZXsrUjogjlwGnBiEg1yfbQgApWJJTmYh8NCCE84YSxI3QcwnuMueDFITpilPGyzOkAfY9DcLWRnXEWK-i-ACx-sJ2Xbgk-Pn8Cvm6d03jmpQ1NH9agtBo_Ot_J1nSrXVJGr5Ox-CX2wHYBv1kNfu6MneMnZ2vptZE1fu39HPzqBB00sg1wur2H6O32Zja5T6bPdw-T8TSp07TokiZTtCyEJqlmjK0P8EylTJE8BUGo0GUj01woGh2wQjOhm4wqBpBpDarhQ3S5mbv07qOH0FULE2poW2nB9aEqBCvjLMEjmW7I2rsQPDTV0puF9KuKkmotvRpPn6r_0mPtfLugVwvQv6Wd5QhcbAEZatk20WRtwh_HCx6_hvMfhg2NhA</recordid><startdate>20110201</startdate><enddate>20110201</enddate><creator>GLANCE, Laurent G</creator><creator>DICK, Andrew W</creator><creator>MUKAMEL, Dana B</creator><creator>FLEMING, Fergal J</creator><creator>ZOLLO, Raymond A</creator><creator>WISSLER, Richard</creator><creator>SALLOUM, Rabih</creator><creator>MEREDITH, U. Wayne</creator><creator>OSLER, Turner M</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20110201</creationdate><title>Association between Intraoperative Blood Transfusion and Mortality and Morbidity in Patients Undergoing Noncardiac Surgery</title><author>GLANCE, Laurent G ; DICK, Andrew W ; MUKAMEL, Dana B ; FLEMING, Fergal J ; ZOLLO, Raymond A ; WISSLER, Richard ; SALLOUM, Rabih ; MEREDITH, U. Wayne ; OSLER, Turner M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c448t-f6b1985d04d222d222e36b42b074e5015d9fa475b105428d25df61b2ee6ddebf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Anemia - epidemiology</topic><topic>Anemia - therapy</topic><topic>Anesthesia</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Causality</topic><topic>Erythrocyte Transfusion - methods</topic><topic>Erythrocyte Transfusion - mortality</topic><topic>Erythrocyte Transfusion - statistics & numerical data</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Intraoperative Care - methods</topic><topic>Lung Diseases - epidemiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Odds Ratio</topic><topic>Postoperative Complications - epidemiology</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Surgical Procedures, Operative</topic><topic>Survival Analysis</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>GLANCE, Laurent G</creatorcontrib><creatorcontrib>DICK, Andrew W</creatorcontrib><creatorcontrib>MUKAMEL, Dana B</creatorcontrib><creatorcontrib>FLEMING, Fergal J</creatorcontrib><creatorcontrib>ZOLLO, Raymond A</creatorcontrib><creatorcontrib>WISSLER, Richard</creatorcontrib><creatorcontrib>SALLOUM, Rabih</creatorcontrib><creatorcontrib>MEREDITH, U. 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Wayne</au><au>OSLER, Turner M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association between Intraoperative Blood Transfusion and Mortality and Morbidity in Patients Undergoing Noncardiac Surgery</atitle><jtitle>Anesthesiology (Philadelphia)</jtitle><addtitle>Anesthesiology</addtitle><date>2011-02-01</date><risdate>2011</risdate><volume>114</volume><issue>2</issue><spage>283</spage><epage>292</epage><pages>283-292</pages><issn>0003-3022</issn><eissn>1528-1175</eissn><coden>ANESAV</coden><abstract>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.
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.
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).
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.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>21239971</pmid><doi>10.1097/aln.0b013e3182054d06</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals |
| subjects | Anemia - epidemiology Anemia - therapy Anesthesia Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Causality Erythrocyte Transfusion - methods Erythrocyte Transfusion - mortality Erythrocyte Transfusion - statistics & numerical data Female Follow-Up Studies Humans Intraoperative Care - methods Lung Diseases - epidemiology Male Medical sciences Middle Aged Odds Ratio Postoperative Complications - epidemiology Retrospective Studies Risk Factors Surgical Procedures, Operative Survival Analysis Survival Rate Treatment Outcome |
| title | Association between Intraoperative Blood Transfusion and Mortality and Morbidity in Patients Undergoing Noncardiac Surgery |
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