Details

Autor(en) / Beteiligte

• Martin, Allison N., MD MPH
• Kerwin, Matthew J., BS
• Turrentine, Florence E., PhD, RN
• Bauer, Todd W., MD
• Adams, Reid B., MD
• Stukenborg, George J., PhD
• Zaydfudim, Victor M., MD MPH

Titel

Blood Transfusion is an Independent Predictor of Morbidity and Mortality after Hepatectomy

Ist Teil von

• The Journal of surgical research, 2016-11, Vol.206 (1), p.106-112

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2016

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract Background Previous studies have indicated that blood transfusion is associated with increased risk of worse outcomes among patients selected for hepatectomy. However, the independent effect of transfusion has not been confirmed. We hypothesize that blood transfusion is an independent factor that affects outcomes in patients undergoing hepatectomy. Materials and Methods Patients at tertiary care center who underwent hepatectomy between 2006 and 2013 were identified and linked with the ACS-NSQIP PUF dataset. Multivariable logistic regression analysis was used to estimate the effect of blood transfusion on 30-day mortality and morbidity, adjusted for differences in extent of resection and estimated probabilities of morbidity and mortality. Results Among 522 patients in the study, 48 (9.2%) patients required perioperative blood transfusion within 72 hours of resection, and 172 (33%) underwent major hepatectomy. Indications for hepatectomy included metastatic neoplasm (n=229, 44%), primary hepatic neoplasm (n=108, 21%), primary extra-hepatic biliary neoplasm (n=23, 4%), and non-malignant indications (n=162, 31%). Eighty-eight (17%) patients had a postoperative morbidity. Blood transfusion was significantly associated with postoperative morbidity (OR 4.18, 95% CI 2.18-8.02, p=0.0001) and mortality (OR 14.5, 95% CI 3.08-67.8, p=001), after adjustment for the concurrent effect of NSQIP estimated probability of morbidity (OR 1.15, 95% CI 0.11-12.2, p=0.042). The extent of resection was not significantly associated with morbidity (OR 1.30, 95% CI 0.74-2.28, p=0.366) or mortality (OR 1.14, 95% CI 0.24-5.50, p=0.870). Conclusions Blood transfusion is a highly statistically significant independent predictor of morbidity and mortality after hepatectomy. Judicious use of perioperative transfusion is indicated in patients with benign and malignant indications for liver resection.