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Article: Analysis of blood transfusion predictors in patients undergoing elective oesophagectomy for cancer

TitleAnalysis of blood transfusion predictors in patients undergoing elective oesophagectomy for cancer
Authors
Issue Date2008
PublisherBioMed Central Ltd.
Citation
BMC Surgery, 2008, v. 8, p. Article no. 3 How to Cite?
AbstractBackground. Oesophagectomy for cancers is a major operation with significant blood loss and usage. Concerns exist about the side effects of blood transfusion, cost and availability of donated blood. We are not aware of any previous study that has evaluated predictive factors for perioperative blood transfusion in patients undergoing elective oesophagectomy for cancer. This study aimed to audit the pattern of blood crossmatch and to evaluate factors predictive of transfusion requirements in oesophagectomy patients. Methods. Data was collected from the database of all patients who underwent oesophagectomy for cancer over a 2-year period. Clinico-pathological data collected included patients demographics, clinical factors, tumour histopathological data, preoperative and discharge haemoglobin levels, total blood loss, number of units of blood crossmatched pre-, intra- and postoperatively, number of blood units transfused, crossmatched units reused for another patient and number of blood units wasted. Clinico-pathological variables were evaluated and logistic regression analysis was performed to determine which factors were predictive of blood transfusion. Results. A total of 145 patients with a male to female ratio of 2.5:1 and median age of 68 (40-85) years were audited. The mean preoperative haemoglobin (Hb) was 13.0 g/dl. 37% of males (Hb < 13.0 g/dl) and 29% of females (Hb < 11.5 g/dl) were anaemic preoperatively. A total of 1241 blood units were crossmatched and 316 units were transfused to 71 patients. Seventy four patients (51%) did not require blood transfusion during their hospital episode. 846 blood units not used for oesophagectomy patients were reused for other patients and 79 units were wasted. The overall crossmatch to transfusion ratio was 4:1 and reuse and wastage rates were 65.2% and 6.3% respectively. The independent predictors of blood transfusion include age >70 years, Hb level <11.0 g/dl, T-stage, presence of postoperative complications and anastomotic leak. Conclusion. The cohort of patients audited was over-crossmatched. The identified independent predictors of blood transfusion should be considered in preoperative blood ordering for oesophagectomy patients. This study has directly led to a reduction in the maximum surgical blood-ordering schedule for oesophagectomy to 2 units and a reaudit is underway. © 2008 Ayantunde et al; licensee BioMed Central Ltd.
Persistent Identifierhttp://hdl.handle.net/10722/205820
ISSN
2015 Impact Factor: 1.469
2015 SCImago Journal Rankings: 0.675

 

DC FieldValueLanguage
dc.contributor.authorAyantunde, AA-
dc.contributor.authorNg, MY-
dc.contributor.authorPal, S-
dc.contributor.authorWelch, NT-
dc.contributor.authorParsons, SL-
dc.date.accessioned2014-10-07T06:03:09Z-
dc.date.available2014-10-07T06:03:09Z-
dc.date.issued2008-
dc.identifier.citationBMC Surgery, 2008, v. 8, p. Article no. 3-
dc.identifier.issn1471-2482-
dc.identifier.urihttp://hdl.handle.net/10722/205820-
dc.description.abstractBackground. Oesophagectomy for cancers is a major operation with significant blood loss and usage. Concerns exist about the side effects of blood transfusion, cost and availability of donated blood. We are not aware of any previous study that has evaluated predictive factors for perioperative blood transfusion in patients undergoing elective oesophagectomy for cancer. This study aimed to audit the pattern of blood crossmatch and to evaluate factors predictive of transfusion requirements in oesophagectomy patients. Methods. Data was collected from the database of all patients who underwent oesophagectomy for cancer over a 2-year period. Clinico-pathological data collected included patients demographics, clinical factors, tumour histopathological data, preoperative and discharge haemoglobin levels, total blood loss, number of units of blood crossmatched pre-, intra- and postoperatively, number of blood units transfused, crossmatched units reused for another patient and number of blood units wasted. Clinico-pathological variables were evaluated and logistic regression analysis was performed to determine which factors were predictive of blood transfusion. Results. A total of 145 patients with a male to female ratio of 2.5:1 and median age of 68 (40-85) years were audited. The mean preoperative haemoglobin (Hb) was 13.0 g/dl. 37% of males (Hb < 13.0 g/dl) and 29% of females (Hb < 11.5 g/dl) were anaemic preoperatively. A total of 1241 blood units were crossmatched and 316 units were transfused to 71 patients. Seventy four patients (51%) did not require blood transfusion during their hospital episode. 846 blood units not used for oesophagectomy patients were reused for other patients and 79 units were wasted. The overall crossmatch to transfusion ratio was 4:1 and reuse and wastage rates were 65.2% and 6.3% respectively. The independent predictors of blood transfusion include age >70 years, Hb level <11.0 g/dl, T-stage, presence of postoperative complications and anastomotic leak. Conclusion. The cohort of patients audited was over-crossmatched. The identified independent predictors of blood transfusion should be considered in preoperative blood ordering for oesophagectomy patients. This study has directly led to a reduction in the maximum surgical blood-ordering schedule for oesophagectomy to 2 units and a reaudit is underway. © 2008 Ayantunde et al; licensee BioMed Central Ltd.-
dc.languageeng-
dc.publisherBioMed Central Ltd.-
dc.relation.ispartofBMC Surgery-
dc.rightsBMC Surgery. Copyright © BioMed Central Ltd.-
dc.titleAnalysis of blood transfusion predictors in patients undergoing elective oesophagectomy for canceren_US
dc.typeArticleen_US
dc.identifier.emailNg, MY: myng2@hku.hk-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1186/1471-2482-8-3-
dc.identifier.pmid18221510-
dc.identifier.scopuseid_2-s2.0-40849094616-
dc.identifier.volume8-
dc.identifier.spageArticle no. 3-
dc.identifier.epageArticle no. 3-
dc.publisher.placeUnited Kingdom-

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