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

2013 ◽  
Vol 23 (9) ◽  
pp. 1612-1619 ◽  
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.

scholarly journals The impact of perioperative packed red blood cell transfusion on survival in epithelial ovarian cancer

2012 ◽  
Vol 127 (1) ◽  
pp. S27 ◽  
Author(s):  
L. Morgenstern ◽  
S. Dowdy ◽  
J. Martin ◽  
M. Lemens ◽  
M. McGree ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Blood Cell ◽  
Epithelial Ovarian Cancer ◽  
Red Blood Cell ◽  
Red Blood Cell Transfusion ◽  
The Impact

scholarly journals Effects of perioperative red blood cell transfusion on systemic immune indicators and postoperative recovery in patients undergoing cesarean section: A propensity score matching analysis

2021 ◽  
Author(s):  
Yilu Zhou ◽  
Yiyi Tao ◽  
Zhendong Xu ◽  
Zhiqiang Liu
Keyword(s):  
Blood Transfusion ◽  
Length Of Stay ◽  
Propensity Score ◽  
Cesarean Section ◽  
Blood Cell ◽  
Postoperative Complication ◽  
Propensity Score Matching ◽  
Red Blood Cell ◽  
Postoperative Recovery ◽  
Red Blood Cell Transfusion

Abstract Background Postpartum hemorrhage (PPH) is one of the leading causes of maternal death in all regions of the world. Intra-operative red blood cell transfusion is one of the most effective strategies to treat PPH. However, the effect of blood transfusion on patients undergoing cesarean section remains unclear. The aim of this study was to investigate the effects of a intra-operative blood transfusion on systemic immune indicators and postoperative recovery in patients undergoing cesarean section. Methods This retrospective study enrolled patients undergoing cesarean section between January 2016 and June 2020. We divided these patients into two groups according to whether they received a intraoperative blood transfusion. Baseline characteristics were compared between groups. After propensity score matching, the length of stay (LOS), perioperative systemic inflammation-based scores, and postoperative complications were compared. Univariate and multivariable Cox proportional hazard models were used to evaluate the associations between covariates and outcomes. Results A total of 1221 patients were enrolled. After propensity score matching, a significant difference in LOS was observed between groups (4.2days vs. 6.6days, P=0.026). The postoperative complication rate in the blood transfusion (BT) group was significantly higher than that in the non-blood transfusion(NBT) group (vomiting, 3.2% vs. 4.9%, P=0.032; fever, 5.41% vs. 2.24%, P=0.032; wound complications, 15.44% vs. 10.45%, P=0.028; intestinal obstructions, 5.88% vs. 2.75%, P=0.034, respectively). The systemic inflammatory indicators fluctuated significantly in the BT group compared with the NBT group on POD1 and POD3. The multivariate analysis indicated that intra-operative blood transfusion was associated with a longer LOS (hazard ratio: 1.52, 95% confidence interval: 1.07, 2.25). Conclusions A intra-operative blood transfusion was associated with fluctuations in systemic inflammatory indicators, higher postoperative complication rates and a prolonged length of stay.

Allogeneic Leukocyte-Reduced Red Blood Cell Transfusion Is Associated with Postoperative Infectious Complications and Cancer Recurrence after Colon Cancer Resection

2019 ◽  
Vol 37 (2) ◽  
pp. 163-170 ◽  
Author(s):  
Andrew-Paul Deeb ◽  
Christopher T. Aquina ◽  
John R.T. Monson ◽  
Neil Blumberg ◽  
Adan Z. Becerra ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Cancer Recurrence ◽  
Infectious Complications ◽  
Oncologic Outcomes ◽  
Red Blood Cell Transfusion ◽  
Elective Resection ◽  
Increased Risk ◽  
The Impact

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.

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

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.

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

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.

Impact of Blood Transfusion in Free Flap Breast Reconstruction Using Propensity Score Matching

2020 ◽  
Author(s):  
Efstathios Karamanos ◽  
Amita R. Shah ◽  
Julie N. Kim ◽  
Howard T. Wang
Keyword(s):  
Postoperative Complications ◽  
Blood Transfusion ◽  
Propensity Score ◽  
Breast Reconstruction ◽  
Propensity Score Matching ◽  
Free Flap ◽  
Improvement Program ◽  
National Quality ◽  
The Impact ◽  
Perioperative Blood Transfusion

Abstract Background Microvascular thrombosis has been associated with cytokine release and inflammatory syndromes which can occur as a result of blood transfusions. This phenomenon could potentially lead to complications in breast free flap reconstruction. The aim of this study was to evaluate the impact of perioperative blood transfusion in free flap breast reconstruction using large population analysis. Methods The American College of Surgeons National Quality Improvement Program database was queried for delayed free flap breast reconstructions performed in 2016. The study population was divided based on perioperative blood transfusion within 24 hours of the start of the operation. Propensity score matching analysis was used to ensure homogeneity between the two study groups. Primary outcome was unplanned return to the operating room (OR) within 30 days. Secondary outcomes were readmission and complications. Results A total of 1,256 patients were identified. Out of those, 91 patients received a perioperative blood transfusion. All the patients received only one unit of PRBC within the first 24 hours. Those patients were matched with similar patients who did not receive a transfusion on a ratio of 1:3 (273 patients). Patients who received a transfusion had a significantly higher incidence of reoperation (42 vs. 10%, p < 0.001). Patients who received a transfusion were more likely to return to the OR after 48 hours from the initial operation (13 vs. 5%, p = 0.001). All returns to the OR were due to flap-related complications. Perioperative blood transfusion increased the incidence of wound dehiscence (9 vs. 2%, p = 0.041) but had no protective effect on the development of other postoperative complications. Conclusion Perioperative blood transfusion in free flap breast reconstruction is associated with an increased probability of flap-related complications and subsequent return to the OR without decreasing the probability of developing other systemic postoperative complications.

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