96: Risk factors for perioperative blood transfusion in patients undergoing hysterectomy for benign disease

Abstract Purpose: The purpose is to identify risk factors for perioperative blood transfusion in patients undergoing hysterectomy for benign disease. Methods: This study is a retrospective chart review including all the patients who underwent hysterectomy for benign disease between January 1st 2018 and December 31st 2019. Patients who received perioperative blood transfusion were identified and compared to those who did not. The following risk factors for blood transfusion were analyzed: route of hysterectomy, BMI, presence of adhesions, history of cesarean section, uterine weight. Descriptive statistics was used to analyze the data. Results: A total of 517 patients were identified and included in the study. Forty-seven patients (9.09 %) received a perioperative blood transfusion. The abdominal hysterectomy route (TAH) was a significant risk factor for receiving blood transfusion (p=0.012). Other identified risk factors for blood transfusion included: Body mass index above 33.0 (p=0.002), and uterine weight (p=0.002). There was no association between the presence of pelvic adhesions (p=0.91) or a personal history of cesarean section (p=0.89) and receiving perioperative blood transfusion. When analyzing only the patients who underwent TLH, the presence of pelvic adhesion was found as a risk factor for perioperative blood transfusion (p=0.024) Conclusion: The abdominal hysterectomy route, the presence of a large uterus, and obesity are risk factors for receiving a blood transfusion. Early identification of the patient at risk of requiring perioperative blood transfusion provides better patient counseling and surgical preparation.

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Risk Factors for Blood Transfusion in Women Undergoing Hysterectomy for Benign Disease

Journal of Gynecologic Surgery ◽

10.1089/gyn.2011.0045 ◽

2012 ◽

Vol 28 (2) ◽

pp. 108-112 ◽

Cited By ~ 2

Author(s):

Catherine A. Matthews ◽

Stephen Cohen ◽

Kathryn Hull ◽

Viswanathan Ramakrishnan ◽

Natasha Reid

Keyword(s):

Risk Factors ◽

Blood Transfusion ◽

Benign Disease

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Risk Factors Analysis of Postoperative Pleural Effusion after Liver Resection

Digestive Surgery ◽

10.1159/000494218 ◽

2018 ◽

Vol 36 (6) ◽

pp. 514-521 ◽

Cited By ~ 2

Author(s):

Kuei-Yen Tsai ◽

Hsin-An Chen ◽

Wan-Yu Wang ◽

Ming-Te Huang

Keyword(s):

Risk Factors ◽

Pleural Effusion ◽

Blood Transfusion ◽

Univariate Analysis ◽

Pulmonary Complications ◽

Older Age ◽

Heavy Smoker ◽

Chronic Obstructive ◽

Heavy Smoking ◽

Perioperative Blood Transfusion

Background: Pulmonary complications remain relatively high in morbidities that arise after liver surgery and are associated with increased length of hospital stay and higher cost. Identification of possible risk factors in this retrospective analysis may help reduce operative morbidity and achieve better outcomes. Methods: In all, 363 consecutive patients underwent elective hepatectomies between July 2008 and November 2013 and these were identified and analyzed retrospectively. Patient demographics and perioperative variables were collected. The main outcome was an analysis of risk factors associated with postoperative pleural effusion (PPE). Results: Of 363 patients receiving hepatectomies, 80 patients (22.0%) developed pulmonary complications. The predominant pulmonary complication in this series is pleural effusion (76 patients, 95%). Univariate analysis found that older age, higher body mass index (BMI), chronic obstructive lung disease, asthma, heart disease, hepatitis C infection, heavy smoking, American Society of Anesthesiology class III and IV, hepatectomy site, combined surgeries, perioperative blood transfusion, and cirrhosis of liver were associated with PPE. Only older age, higher BMI, asthma, heavy smoker, combined gastrointestinal surgeries, and perioperative blood transfusion were identified as independent risk factors in multivariate analysis. Conclusion: This study identifies 6 risk factors for PPE. Identification and management of some of these factors could possibly reduce morbidity and improve short-term surgical outcomes.

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Perioperative blood transfusion in cancer patients undergoing laparoscopic colorectal resection: risk factors and impact on survival

Techniques in Coloproctology ◽

10.1007/s10151-013-1014-y ◽

2013 ◽

Vol 17 (5) ◽

pp. 549-554 ◽

Cited By ~ 16

Author(s):

R. Ghinea ◽

R. Greenberg ◽

I. White ◽

E. Sacham-Shmueli ◽

H. Mahagna ◽

...

Keyword(s):

Risk Factors ◽

Blood Transfusion ◽

Cancer Patients ◽

Colorectal Resection ◽

Laparoscopic Colorectal Resection ◽

Impact On Survival ◽

Perioperative Blood Transfusion

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Development and validation of a nomogram to predict perioperative blood transfusion for gastric cancer surgery

10.21203/rs.3.rs-30326/v1 ◽

2020 ◽

Author(s):

Haoquan Huang ◽

Zhixiao Han ◽

Xia Liang ◽

Zhongqi Liu ◽

Shi Cheng ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Blood Transfusion ◽

Goodness Of Fit ◽

Validation Cohort ◽

Cancer Surgery ◽

Goodness Of Fit Test ◽

Gastric Cancer Surgery ◽

Independent Risk Factors ◽

Perioperative Blood Transfusion

Abstract Background This study aimed to construct and validate a nomogram composed of preoperative variables to predict perioperative blood transfusion for gastric cancer surgery. Methods 600 gastric cancer patients undergoing gastrectomy between January 2010 and December 2015 were selected as primary cohort. 399 patients from January 2016 to June 2019 were collected as validation cohort. In the primary cohort, univariate and multivariate analyses were performed to identify independent risk factors for blood transfusion. Using Akaike information criterion, selected variables were incorporated to construct a nomogram. Validations of the nomogram were performed in the primary and validation cohort. Discrimination of the nomogram was assessed by the concordance index (C-index) and calibration of the nomogram was assessed by calibration curve and Hosmer–Lemeshow goodness-of-fit test. Results The following independent risk factors for transfusion were identified: Charlson comorbidity index score over 3 (odds ratio (OR) 2.15), tumor location (diffuse vs upper: OR 1.50), pTNM stage (III vs I: OR 3.17), type of gastrectomy (subtotal vs total gastrectomy: OR 0.58), extragastric organ resection (OR 2.03) and preoperative hemoglobin less than 80 g/l (vs over 120 g/l: OR 66.03). C-index was 0.863 and 0.901 in the primary and validation cohort, respectively, indicating good discrimination of the nomogram. Both calibration curves and Hosmer–Lemeshow goodness-of-fit tests (P-value 0.716 and 0.935) demonstrated high agreement between prediction and actual outcome. Conclusion A nomogram composed of preoperative variables to predict blood transfusion for gastric cancer surgery was developed and validated. This nomogram could be used to improve utilization of packed red blood cells.

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Prolonged length of stay and discharge disposition to rehabilitation facilities following single-level posterior lumbar interbody fusion for acquired spondylolisthesis

Surgical Neurology International ◽

10.25259/sni_707_2020 ◽

2020 ◽

Vol 11 ◽

pp. 411

Author(s):

Joshua Alexander Benton ◽

Rafael De La Garza Ramos ◽

Yaroslav Gelfand ◽

Jonathan D. Krystal ◽

Vijay Yanamadala ◽

...

Keyword(s):

Risk Factors ◽

Blood Transfusion ◽

Length Of Stay ◽

Interbody Fusion ◽

Posterior Lumbar Interbody Fusion ◽

Lumbar Interbody Fusion ◽

Prolonged Length ◽

Single Level ◽

Rehabilitation Facilities ◽

Perioperative Blood Transfusion

Background: Acquired lumbar spondylolisthesis is often treated with interbody fusion. However, few studies have evaluated predictors for prolonged length of stay (LOS) and disposition to rehabilitation facilities after posterior single-level lumbar interbody fusion for acquired spondylolisthesis. Methods: The American College of Surgeons National Quality Improvement Program database was queried for adults with acquired spondylolisthesis who underwent single-level lumbar interbody fusion through a posterior approach (posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion [TLIF]). We utilized multivariate logistic regression analysis to identify predictors of prolonged LOS and disposition in this patient population. Results: Among 2080 patients identified, 700 (33.7%) had a prolonged LOS (≥4 days), and 306 (14.7%) were discharged postoperatively to rehabilitation facilities. Predictors for prolonged LOS included: American Society of Anesthesiologist (ASA) class ≥3, anemia, prolonged operative time, perioperative blood transfusion, pneumonia, urinary tract infections, and return to the operating room. The following risk factors predicted discharge to postoperative rehabilitation facilities: age ≥65 years, male sex, ASA class ≥3, modified frailty score ≥2, perioperative blood transfusion, and prolonged LOS. Conclusion: Multiple partial-overlapping risk factors predicted prolonged LOS and discharge to rehabilitation facilities after single-level TLIF/PLIF performed for acquired spondylolisthesis.

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Risk factors analysis of hyperbilirubinemia after off-pump coronary artery bypass grafting: a retrospective observational study

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01678-6 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Yingdi Gao ◽

Dongjie Li ◽

Honghong Dong ◽

Yulin Guo ◽

Yuanshu Peng ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Blood Transfusion ◽

Logistic Regression Analysis ◽

Total Bilirubin ◽

Serum Total Bilirubin ◽

Preoperative Serum ◽

Independent Risk Factors ◽

Perioperative Blood Transfusion

Abstract Background Hyperbilirubinemia is a common complication after off-pump coronary artery bypass grafting (OPCAB), but the incidence and the risk factors are unclear. This study aimed to analyze the incidence and risk factors of postoperative hyperbilirubinemia in patients undergoing OPCAB. Methods From December 2016 to March 2019, a total of 416 consecutive patients undergoing OPCAB were enrolled in this single-center retrospective study. Patients were divided into the normal serum total bilirubin group and the hyperbilirubinemia group based on the serum total bilirubin levels. Perioperative variables between the two groups were compared by univariate logistic regression analysis. Then, multivariate binary logistic regression analysis was used to analyze the independent risk factors of developing hyperbilirubinemia in patients underwent OPCAB. P < 0.05 was considered as statistically significant. Results Thirty two of 416 (7.7%) patients developed postoperative hyperbilirubinemia. Univariate regression analysis showed significant differences in gender (73.96% vs. 93.75%, P = 0.012), preoperative total bilirubin levels (11.92 ± 4.52 vs. 18.28 ± 7.57, P < 0.001), perioperative IABP implantation (22.66% vs. 43.75%, P = 0.008), perioperative blood transfusion (37.50% vs. 56.25%, P = 0.037) between the two groups. Multivariate logistic regression analysis revealed that elevated preoperative serum total bilirubin levels (OR = 1.225, 95% CI 1.145–1.310, P < 0.001), perioperative blood transfusion (OR = 4.488, 95% CI 1.876–10.737, P = 0.001) and perioperative IABP implantation (OR = 4.016, 95% CI 1.709–9.439, P = 0.001) were independent risk factors for hyperbilirubinemia after OPCAB. Conclusions Hyperbilirubinemia is also a common complication after OPCAB. Elevated preoperative serum total bilirubin levels, perioperative blood transfusion, and perioperative IABP implantation were independent risk factors for patients developing hyperbilirubinemia after OPCAB. Further studies need to be conducted to confirm the risk factors of hyperbilirubinemia after OPCAB procedure.

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Association between type of anesthesia and length of hospital stay in primary unilateral total knee arthroplasty patients: a single-center retrospective study

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02817-4 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Xiaoqing Wang ◽

He Li ◽

Conghu Yuan ◽

Hang Zhao

Keyword(s):

Risk Factors ◽

Total Knee Arthroplasty ◽

Blood Transfusion ◽

Elderly Patients ◽

General Anesthesia ◽

Regional Anesthesia ◽

Length Of Hospital Stay ◽

Regression Analyses ◽

Total Knee ◽

Perioperative Blood Transfusion

Abstract Objective This study explored the risk factors influencing the length of hospital stay (LOS) and establish whether the type of anesthesia is independently associated with the LOS in patients after primary unilateral total knee arthroplasty (TKA). Methods In this retrospective cohort study, 2309 patients undergoing unilateral TKA were recruited between January 2013 and June 2014 in a tertiary academic medical center in Singapore. Univariate and multivariate linear regression analyses were used to identify the independent risk factors associated with LOS. Besides, subgroup and interaction analyses were performed to evaluate the relationship between the type of anesthesia and LOS. Result In total, 2309 patients were identified. Out of these, 791 patients underwent general anesthesia, whereas 1518 patients underwent regional anesthesia. Multivariate regression analyses revealed that prolonged LOS was significantly associated with age ≥ 65 years (β = 0.48; 95% CI, 0.09–0.87; P = 0.015), diabetes mellitus (DM) (β = 0.8; 95% CI, 0.33–1.27; P = 0.001), congestive cardiac failure (CCF) (β = 4.1; 95% CI, 2.02–6.17; P < 0.001), perioperative blood transfusion (β = 5.71; 95% CI, 4.86–6.56; P < 0.001), creatinine > 2 mg/dL (β = 4.54; 95% CI, 2.46–6.62; P < 0.001), ASA status (III) (β = 1.72; 95% CI, 0.72–2.71; P = 0.001), general anesthesia (β = 0.78; 95% CI, 0.41–1.66; P < 0.001). The LOS further decreased among participants receiving regional anesthesia at advanced age (age ≥ 65 years) (β = − 1.12; 95% CI, − 1.66 to − 0.58; P < 0.001), patients with BMI ≤ 25 kg/m2 (β = − 1.92; 95% CI, − 2.73 to − 1.11; P < 0.001) or ≥ 30 kg/m2 (β = − 0.58; 95% CI, − 1.1 to − 0.06; P = 0.029). Conclusion Our findings demonstrated that age ≥ 65 years, DM, CCF, perioperative blood transfusion, creatinine > 2 mg/dL, ASA status (III), general anesthesia are associated with a prolonged LOS after primary TKA. Elderly patients (age ≥ 65 years) and patients with BMI ≤ 25 kg/m2 or ≥ 30 kg/m2 receiving regional anesthesia have a further reduced LOS. Therefore, when TKA is performed, priority for regional anesthesia is given to the elderly patients (age ≥ 65 years old) and those with BMI ≤ 25 kg/m2 or ≥ 30 kg/m2.

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