Sex based analysis of the impact of red blood cell transfusion and vascular or bleeding complications related to TAVI – The TRITAVI-Women Study

Background/Aims: Transfusion rates in colon cancer surgery are traditionally very high. Allogeneic red blood cell (RBC) transfusions are reported to induce immunomodulation that contributes to infectious morbidity and adverse oncologic outcomes. In an effort to attenuate these effects, the study institution implemented a universal leukocyte reduction protocol. The purpose of this study was to examine the impact of leukocyte-reduced (LR) transfusions on postoperative infectious complications, recurrence-free survival, and overall survival (OS). Methods: In a retrospective study, patients with stage I–III adenocarcinoma of the colon from 2003 to 2010 who underwent elective resection were studied. The primary outcome measures were postoperative infectious complications and recurrence-free and OS in patients that received a transfusion. Bivariate and multivariable regression analyses were performed for each endpoint. Results: Of 294 patients, 66 (22%) received a LR RBC transfusion. After adjustment, transfusion of LR RBCs was found to be independently associated with increased infectious complications (OR 3.10, 95% CI 1.24–7.73), increased odds of cancer recurrence (hazard ratio [HR] 3.74, 95% CI 1.94–7.21), and reduced OS when ≥3 units were administered (HR 2.24, 95% CI 1.12–4.48). Conclusion: Transfusion of LR RBCs is associated with an increased risk of infectious complications and worsened survival after elective surgery for colon cancer, irrespective of leukocyte reduction.

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The Impact of Perioperative Packed Red Blood Cell Transfusion on Survival in Epithelial Ovarian Cancer

International Journal of Gynecological Cancer ◽

10.1097/01.igc.0000436089.03581.6b ◽

2013 ◽

Vol 23 (9) ◽

pp. 1612-1619 ◽

Cited By ~ 16

Author(s):

Lindsay L. Morgenstern Warner ◽

Sean C. Dowdy ◽

Janice R. Martin ◽

Maureen A. Lemens ◽

Michaela E. McGree ◽

...

Keyword(s):

Ovarian Cancer ◽

Propensity Score ◽

Blood Cell ◽

Epithelial Ovarian Cancer ◽

Propensity Score Matching ◽

Red Blood Cell ◽

Red Blood Cell Transfusion ◽

Improvement Program ◽

Estimated Blood Loss ◽

The Impact

ObjectivePerioperative packed red blood cell transfusion (PRBCT) has been implicated as a negative prognostic marker in surgical oncology. There is a paucity of evidence on the impact of PRBCT on outcomes in epithelial ovarian cancer (EOC). We assessed whether PRBCT is an independent risk factor of recurrence and death from EOC.MethodsPerioperative patient characteristics and process-of-care variables (defined by the National Surgical Quality Improvement Program) were retrospectively abstracted from 587 women who underwent primary EOC staging between January 2, 2003, and December 29, 2008. Associations with receipt of PRBCT were evaluated using univariate logistic regression models. The associations between receipt of PRBCT and disease-free survival and overall survival were evaluated using multivariable Cox proportional hazards models and using propensity score matching and stratification, respectively.ResultsThe rate of PRBCT was 77.0%. The mean ± SD units transfused was 4.1 ± 3.1 U. In the univariate analysis, receipt of PRBCT was significantly associated with older age, advanced stage (≥IIIA), undergoing splenectomy, higher surgical complexity, serous histologic diagnosis, greater estimated blood loss, longer operating time, the presence of residual disease, and lower preoperative albumin and hemoglobin. Perioperative packed red blood cell transfusion was not associated with an increased risk for recurrence or death, in an analysis adjusting for other risk factors in a multivariable model or in an analysis using propensity score matching or stratification to control for differences between the patients with and without PRBCT.ConclusionsPerioperative packed red blood cell transfusion does not seem to be directly associated with recurrence and death in EOC. However, lower preoperative hemoglobin was associated with a higher risk for recurrence. The need for PRBCT seems to be a stronger prognostic indicator than the receipt of PRBCT.

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Perioperative red blood cell transfusion is associated with poor functional outcome and overall survival in patients with newly diagnosed glioblastoma

Neurosurgical Review ◽

10.1007/s10143-021-01633-y ◽

2021 ◽

Author(s):

Matthias Schneider ◽

Niklas Schäfer ◽

Anna-Laura Potthoff ◽

Leonie Weinhold ◽

Lars Eichhorn ◽

...

Keyword(s):

Overall Survival ◽

Blood Cell ◽

Red Blood Cell ◽

Multivariate Regression Analysis ◽

Median Number ◽

Red Blood Cell Transfusion ◽

Newly Diagnosed ◽

Newly Diagnosed Glioblastoma ◽

The Impact ◽

Rbc Transfusion

AbstractThe influence of perioperative red blood cell (RBC) transfusion on prognosis of glioblastoma patients continues to be inconclusive. The aim of the present study was to evaluate the association between perioperative blood transfusion (PBT) and overall survival (OS) in patients with newly diagnosed glioblastoma. Between 2013 and 2018, 240 patients with newly diagnosed glioblastoma underwent surgical resection of intracerebral mass lesion at the authors’ institution. PBT was defined as the transfusion of RBC within 5 days from the day of surgery. The impact of PBT on overall survival was assessed using Kaplan–Meier analysis and multivariate regression analysis. Seventeen out of 240 patients (7%) with newly diagnosed glioblastoma received PBT. The overall median number of blood units transfused was 2 (95% CI 1–6). Patients who received PBT achieved a poorer median OS compared to patients without PBT (7 versus 18 months; p < 0.0001). Multivariate analysis identified “age > 65 years” (p < 0.0001, OR 6.4, 95% CI 3.3–12.3), “STR” (p = 0.001, OR 3.2, 95% CI 1.6–6.1), “unmethylated MGMT status” (p < 0.001, OR 3.3, 95% CI 1.7–6.4), and “perioperative RBC transfusion” (p = 0.01, OR 6.0, 95% CI 1.5–23.4) as significantly and independently associated with 1-year mortality. Perioperative RBC transfusion compromises survival in patients with glioblastoma indicating the need to minimize the use of transfusions at the time of surgery. Obeying evidence-based transfusion guidelines provides an opportunity to reduce transfusion rates in this population with a potentially positive effect on survival.

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Red Blood Cell Transfusion Practices in the Neurointensive Care Unit: A Narrative Review

Journal of Neuroanaesthesiology and Critical Care ◽

10.1055/s-0039-1685251 ◽

2019 ◽

Vol 06 (02) ◽

pp. 072-079

Author(s):

Rohini M. Surve ◽

Sonia Bansal ◽

Radhakrishnan Muthuchellappan

Keyword(s):

Blood Transfusion ◽

Blood Cell ◽

Red Blood Cell ◽

Narrative Review ◽

Neurointensive Care ◽

Red Blood Cell Transfusion ◽

Compensatory Mechanism ◽

Neurointensive Care Unit ◽

The Impact ◽

The Brain

AbstractAnemia is common in neurointensive care unit (NICU) patients and is one of the common causes of systemic insults to the brain. Though the recent literature favors restrictive blood transfusion practices over liberal transfusion to correct anemia in the general ICU, whether a similar practice can be adopted in NICU patients is doubtful due to lack of strong evidence. Impairment of cerebral autoregulation and cardiac function following acute brain injury affects the body's compensatory mechanism to anemia and renders the brain susceptible to anemic hypoxia at different hemoglobin (Hb) thresholds. Hence, red blood cell transfusion (RBCT) practice based on a single Hb threshold value might be inappropriate. On the other hand, allogenic RBCT has its own risks, both in short and in long run, leading to adverse outcomes. Thus, instead of relying only on arbitrary Hb values, a better way to decide the need for RBCT in NICU patients is to target parameters based on systemic and regional cerebral oxygenation. This approach will help us to individualize RBCT practices. In this narrative review, based on the available literature, authors have discussed the impact of anemia and blood transfusion on the immediate and late neurological outcomes and the current role of regional brain monitoring in guiding blood transfusion practices. In the end, authors have tried to update on the current RBCT practices in neurosurgical and neuromedical patients admitted to the NICU.

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