TY - JOUR
T1 - Effect of intraoperative red blood cell transfusion on postoperative complications after open radical cystectomy
T2 - Old versus fresh stored blood
AU - Lee, Seung Jun
AU - Seo, Hyungseok
AU - Kim, Hyun Chang
AU - Lim, Seon Min
AU - Yoon, So Jeong
AU - Kim, Hyung Suk
AU - Ku, Ja Hyeon
AU - Park, Hee Pyoung
N1 - Publisher Copyright:
© 2015 Elsevier Inc. All rights reserved.
PY - 2015/12
Y1 - 2015/12
N2 - 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.
AB - 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.
KW - Blood storage duration
KW - Blood transfusion
KW - Cystectomy
KW - Postoperative complications
UR - http://www.scopus.com/inward/record.url?scp=84947868304&partnerID=8YFLogxK
U2 - 10.1016/j.clgc.2015.06.002
DO - 10.1016/j.clgc.2015.06.002
M3 - Article
C2 - 26165733
AN - SCOPUS:84947868304
SN - 1558-7673
VL - 13
SP - 581
EP - 587
JO - Clinical Genitourinary Cancer
JF - Clinical Genitourinary Cancer
IS - 6
ER -