The impact of blood transfusion on perioperative outcomes following gastric cancer resection: An analysis of the American College of Surgeons National Surgical Quality Improvement Program database

Maryam Elmi, Alyson Mahar, Daniel Kagedan, Calvin H.L. Law, Paul J. Karanicolas, Yulia Lin, Jeannie Callum, Natalie G. Coburn, Julie Hallet

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

Background: Red blood cell transfusions (RBCT) carry risk of transfusion-related immunodulation that may impact postoperative recovery. This study examined the association between perioperative RBCT and short-term postoperative outcomes following gastrectomy for gastric cancer. Methods: Using the American College of Surgeons National Surgical Quality Improvement Program database, we compared outcomes of patients (transfused v. nontransfused) undergoing elective gastrectomy for gastric cancer (2007-2012). Outcomes were 30-day major morbidity, mortality and length of stay. The association between perioperative RBCT and outcomes was estimated using modified Poisson, logistic, or negative binomial regression. Results: Of the 3243 patients in the entire cohort, we included 2884 patients with nonmissing data, of whom 535 (18.6%) received RBCT. Overall 30-day major morbidity and mortality were 20% and 3.5%, respectively. After adjustment for baseline and clinical characteristics, RBCT was independently associated with increased 30-day mortality (relative risk [RR] 3.1, 95% confidence interval [CI] 1.9-5.0), major morbidity (RR 1.4, 95% CI 1.2-1.8), length of stay (RR 1.2, 95% CI 1.1-1.2), infections (RR 1.4, 95% CI 1.1-1.6), cardiac complications (RR 1.8, 95% CI 1.0-3.2) and respiratory failure (RR 2.3, 95% CI 1.6-3.3). Conclusion: Red blood cell transfusions are associated with worse postoperative short-term outcomes in patients with gastric cancer. Blood management strategies are needed to reduce the use of RBCT after gastrectomy for gastric cancer.

Original languageEnglish (US)
Pages (from-to)322-329
Number of pages8
JournalCanadian Journal of Surgery
Volume59
Issue number5
DOIs
StatePublished - Oct 2016
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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