Seung-Jun Lee1, Hyungseok Seo1, Hyun-Chang Kim1, Seon-Min Lim1, So Jeong Yoon1, Hyung Suk Kim2, Ja Hyeon Ku2, Hee-Pyoung Park3. 1. Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea. 2. Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea. 3. Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: hppark@snu.ac.kr.
Abstract
INTRODUCTION: Transfusion with red blood cells (RBCs) is associated with adverse clinical outcomes. We determined whether an intraoperative RBC transfusion is related to postoperative complications in patients undergoing open radical cystectomy. We also compared the effect of transfusion with fresh versus old blood on postoperative complications. PATIENTS AND METHODS: A total of 261 patients undergoing open radical cystectomy were divided into no-transfusion or transfusion groups. Transfused patients were divided according to RBC storage duration (fresh, ≤ 14 days; old, > 14 days). Postoperative complications, such as infection, paralytic ileus, urinary tract obstruction, and anastomotic leak, were noted. RESULTS: Infection (26.5%) was the most common postoperative complication, followed by procedural (17.6%), gastrointestinal (16.7%), renal (13.7%), and vascular (10.5%) problems. Age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.00-1.07; P = .029), urinary diversion with a neobladder (OR, 2.30; 95% CI, 1.29-4.11; P = .005), and intraoperative RBC transfusion (OR, 1.77; 95% CI, 1.02-3.07; P = .042) were independent predictors of postoperative complications in a binary logistic analysis. Patients (n = 172; old blood, n = 47; fresh blood, n = 116; mixed blood, n = 9) who received an intraoperative RBC transfusion had a higher incidence of postoperative complications than those (n = 89) who did not undergo intraoperative transfusion (65.1% vs. 49.4%, P < .05). No difference in the incidence of postoperative complications between transfusions with old blood and fresh blood was observed (63.8% vs. 65.5%). CONCLUSION: Intraoperative RBC transfusion is associated with increased postoperative complications in patients undergoing open radical cystectomy. The RBC storage duration may not affect the incidence of postoperative complications in this study population.
INTRODUCTION: Transfusion with red blood cells (RBCs) is associated with adverse clinical outcomes. We determined whether an intraoperative RBC transfusion is related to postoperative complications in patients undergoing open radical cystectomy. We also compared the effect of transfusion with fresh versus old blood on postoperative complications. PATIENTS AND METHODS: A total of 261 patients undergoing open radical cystectomy were divided into no-transfusion or transfusion groups. Transfused patients were divided according to RBC storage duration (fresh, ≤ 14 days; old, > 14 days). Postoperative complications, such as infection, paralytic ileus, urinary tract obstruction, and anastomotic leak, were noted. RESULTS:Infection (26.5%) was the most common postoperative complication, followed by procedural (17.6%), gastrointestinal (16.7%), renal (13.7%), and vascular (10.5%) problems. Age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.00-1.07; P = .029), urinary diversion with a neobladder (OR, 2.30; 95% CI, 1.29-4.11; P = .005), and intraoperative RBC transfusion (OR, 1.77; 95% CI, 1.02-3.07; P = .042) were independent predictors of postoperative complications in a binary logistic analysis. Patients (n = 172; old blood, n = 47; fresh blood, n = 116; mixed blood, n = 9) who received an intraoperative RBC transfusion had a higher incidence of postoperative complications than those (n = 89) who did not undergo intraoperative transfusion (65.1% vs. 49.4%, P < .05). No difference in the incidence of postoperative complications between transfusions with old blood and fresh blood was observed (63.8% vs. 65.5%). CONCLUSION: Intraoperative RBC transfusion is associated with increased postoperative complications in patients undergoing open radical cystectomy. The RBC storage duration may not affect the incidence of postoperative complications in this study population.
Authors: Meera R Chappidi; Heather J Chalfin; Daniel J Johnson; Max Kates; Nikolai A Sopko; Michael H Johnson; Jen-Jane Liu; Steven M Frank; Trinity J Bivalacqua Journal: Urol Oncol Date: 2016-10-19 Impact factor: 3.498