Predictive models for significant intraoperative blood loss (18.1%) and perioperative transfusion (12.3%) in colorectal cancer surgery achieved AUCs of 0.836 and 0.934, respectively.
Cohort (n=706)
Significant intraoperative blood loss and perioperative transfusion in colorectal cancer surgery have distinct risk factors, with SIBL reflecting surgical complexity and PTF reflecting impaired physiological reserve.
ABSTRACT Background Significant intraoperative blood loss (SIBL) and perioperative transfusion (PTF) are major concerns in colorectal cancer (CRC) surgery, yet they are often considered sequential events despite potentially distinct mechanisms. Methods We retrospectively analysed 706 patients who underwent curative resection for non‐metastatic CRC. Logistic LASSO regression was used to identify predictors for SIBL (> 200 mL) and PTF. Model performance was evaluated using area under the curve (AUC), calibration metrics, and 1000 bootstrap validation. Results SIBL occurred in 18.1% of patients, and PTF was required in 12.3%. Independent predictors of SIBL included rectal cancer, preoperative radio‐ or chemotherapy, and surgeon experience less than 3 years, while minimally invasive surgery was associated with a reduced risk. In contrast, predictors of PTF included haemoglobin 5 ng/mL, congestive heart failure, and renal dysfunction. cT4 stage, concurrent resection and platelet 500 mL showed an AUC of 0.843 (95% CI: 0.763–0.924). Conclusion Our findings suggest that SIBL and PTF arise from different risk factors. SIBL reflects surgical complexity, whereas PTF reflects impaired physiological reserve. Further research is warranted to validate these models in diverse cohorts to establish preventive strategies for these adverse outcomes.
Lee et al. (Sun,) conducted a cohort in non-metastatic colorectal cancer (n=706). Risk factors for surgical bleeding and transfusion was evaluated on Significant intraoperative blood loss (> 200 mL) and perioperative transfusion. Predictive models for significant intraoperative blood loss (18.1%) and perioperative transfusion (12.3%) in colorectal cancer surgery achieved AUCs of 0.836 and 0.934, respectively.