Influence of transfusions on perioperative and long-term outcome in patients following hepatic resection for colorectal metastases Journal Article
| Authors: | Kooby, D. A.; Stockman, J.; Ben-Porat, L.; Gonen, M.; Jarnagin, W. R.; DeMatteo, R. P.; Tuorto, S.; Wuest, D.; Blumgart, L. H.; Fong, Y. |
| Article Title: | Influence of transfusions on perioperative and long-term outcome in patients following hepatic resection for colorectal metastases |
| Abstract: | Objective: To determine if transfusion affected perioperative and long-term outcome in patients undergoing liver resection for metastatic colorectal cancer. Summary Background Data: Blood transfusion produces host immunosuppression and has been postulated to result in adverse outcome for patients undergoing surgical resection of malignancies. Methods: Blood transfusion records and clinical outcomes for 1,351 patients undergoing liver resection at a tertiary cancer referral center were analyzed. Results: Blood transfusion was a-ssociated n-with adverse outcome after liver resection. The greatest effect was in the perioperative course, where transfusion was an independent predictor of operative mortality, complications, major complications, and length of hospital stay. This effect was dose-related. Patients receiving one or two units or more than two units had an operative mortality of 2.5% and 11.1%, respectively, compared to 1.2% for patients not requiring transfusions. Transfusion was also associated with adverse long-term survival by univariate analysis, but this factor was not significant on multivariate analysis. Even patients receiving only one or two units had a more adverse outcome. Conclusions: Perioperative blood transfusion is a risk factor for poor outcome after liver resection. Blood conservation methods should be used to avoid transfusion, especially in patents currently requiring limited amounts of transfused blood products. |
| Keywords: | survival; treatment outcome; middle aged; survival analysis; cancer surgery; major clinical study; disease course; mortality; dose response; liver neoplasms; conference paper; colorectal cancer; disease association; metastasis; risk factors; pathology; prediction; risk factor; postoperative complication; colorectal neoplasms; survival time; length of stay; hospitalization; colorectal tumor; liver tumor; medical record; blood transfusion; liver resection; surgical mortality; hepatectomy; visceral metastasis; multivariate analysis; immunosuppressive treatment; patient referral; blood storage; humans; human; male; female; priority journal; article |
| Journal Title: | Annals of Surgery |
| Volume: | 237 |
| Issue: | 6 |
| ISSN: | 0003-4932 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2003-06-01 |
| Start Page: | 860 |
| End Page: | 870 |
| Language: | English |
| DOI: | 10.1097/00000658-200306000-00015 |
| PUBMED: | 12796583 |
| PROVIDER: | scopus |
| PMCID: | PMC1514683 |
| DOI/URL: | |
| Notes: | Presented at the 114th Annual Session of the Southern Surgical Association; 2002 Dec 1-4; Palm Beach, FL; Export Date: 25 September 2014 -- Source: Scopus |
