Intraoperative blood transfusion in severely anemic patients undergoing noncardiac surgery was associated with an increased risk of 30-day mortality (OR 1.29; 95% CI 1.03-1.62).
Cohort (n=10,100)
Does intraoperative erythrocyte transfusion increase 30-day mortality and morbidity in severely anemic patients undergoing noncardiac surgery?
In severely anemic patients undergoing noncardiac surgery, intraoperative transfusion of 1-2 units of erythrocytes is associated with increased 30-day mortality and morbidity.
Odds Ratio: 1.29 (95% CI 1.03–1.62)
BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.
Glance et al. (2011) conducted a cohort in Severe anemia undergoing noncardiac surgery (n=10,100). Intraoperative blood transfusion vs. No intraoperative transfusion was evaluated on 30-day mortality (OR 1.29, 95% CI 1.03-1.62). Intraoperative blood transfusion in severely anemic patients undergoing noncardiac surgery was associated with an increased risk of 30-day mortality (OR 1.29; 95% CI 1.03-1.62).