Impact of Perioperative Blood Transfusions on Outcomes After Hyperthermic Intraperitoneal Chemotherapy : A Propensity-Matched Analysis
BACKGROUND: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is a major operation frequently necessitating red blood cell transfusion. Using multi-institutional data from the U.S. HIPEC Collaborative, this study sought to determine the association of perioperative allogenic blood transfusion (PABT) with perioperative outcomes after CRS/HIPEC.
METHODS: This retrospective cohort study analyzed patients who underwent CRS/HIPEC for peritoneal surface malignancy between 2000 and 2017. Propensity score-matching was performed to mitigate bias. Univariate analysis was used to compare demographic, preoperative, intraoperative, and postoperative variables. Factors independently associated with PABT were identified using multivariate analysis.
RESULTS: The inclusion criteria were met by 1717 patients, 510 (29.7%) of whom required PABT. The mean Peritoneal Cancer Index (PCI) of our cohort was 14.8 ± 9.3. Propensity score-matching showed an independent association between PABT and postoperative risk of pleural effusion, hemorrhage, pulmonary embolism, enteric fistula formation, Clavien-Dindo grades 3 and 4 morbidity, longer hospital stay, and reoperation (all P < 0.05 in the multivariate analysis). Compared with the patients who received 1 to 5 red blood cell (RBC) units, the patients who received more than 5 units had a greater risk of renal impairment, a longer intensive care unit (ICU) stay, and more postoperative infections. Finally, PABT was an independent predictor of worse survival for patients with appendiceal and colorectal primaries.
CONCLUSION: Even low levels of PABT for patients undergoing CRS/HIPEC are independently associated with a greater risk of infectious and non-infectious postoperative complications, and this risk is increased for patients receiving more than 5 RBC units. Worse survival was independently predicted by PABT for patients with peritoneal carcinomatosis of an appendiceal or colorectal origin.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:28 |
|---|---|
| Enthalten in: |
Annals of surgical oncology - 28(2021), 8 vom: 28. Aug., Seite 4499-4507 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Kubi, Boateng [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 08.07.2021 Date Revised 08.07.2021 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1245/s10434-020-09501-7 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM320690962 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM320690962 | ||
| 003 | DE-627 | ||
| 005 | 20231225174121.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1245/s10434-020-09501-7 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1068.xml |
| 035 | |a (DE-627)NLM320690962 | ||
| 035 | |a (NLM)33507449 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Kubi, Boateng |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Impact of Perioperative Blood Transfusions on Outcomes After Hyperthermic Intraperitoneal Chemotherapy |b A Propensity-Matched Analysis |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 08.07.2021 | ||
| 500 | |a Date Revised 08.07.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is a major operation frequently necessitating red blood cell transfusion. Using multi-institutional data from the U.S. HIPEC Collaborative, this study sought to determine the association of perioperative allogenic blood transfusion (PABT) with perioperative outcomes after CRS/HIPEC | ||
| 520 | |a METHODS: This retrospective cohort study analyzed patients who underwent CRS/HIPEC for peritoneal surface malignancy between 2000 and 2017. Propensity score-matching was performed to mitigate bias. Univariate analysis was used to compare demographic, preoperative, intraoperative, and postoperative variables. Factors independently associated with PABT were identified using multivariate analysis | ||
| 520 | |a RESULTS: The inclusion criteria were met by 1717 patients, 510 (29.7%) of whom required PABT. The mean Peritoneal Cancer Index (PCI) of our cohort was 14.8 ± 9.3. Propensity score-matching showed an independent association between PABT and postoperative risk of pleural effusion, hemorrhage, pulmonary embolism, enteric fistula formation, Clavien-Dindo grades 3 and 4 morbidity, longer hospital stay, and reoperation (all P < 0.05 in the multivariate analysis). Compared with the patients who received 1 to 5 red blood cell (RBC) units, the patients who received more than 5 units had a greater risk of renal impairment, a longer intensive care unit (ICU) stay, and more postoperative infections. Finally, PABT was an independent predictor of worse survival for patients with appendiceal and colorectal primaries | ||
| 520 | |a CONCLUSION: Even low levels of PABT for patients undergoing CRS/HIPEC are independently associated with a greater risk of infectious and non-infectious postoperative complications, and this risk is increased for patients receiving more than 5 RBC units. Worse survival was independently predicted by PABT for patients with peritoneal carcinomatosis of an appendiceal or colorectal origin | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Nudotor, Richard |e verfasserin |4 aut | |
| 700 | 1 | |a Fackche, Nadege |e verfasserin |4 aut | |
| 700 | 1 | |a Nizam, Wasay |e verfasserin |4 aut | |
| 700 | 1 | |a Cloyd, Jordan M |e verfasserin |4 aut | |
| 700 | 1 | |a Grotz, Travis E |e verfasserin |4 aut | |
| 700 | 1 | |a Fournier, Keith F |e verfasserin |4 aut | |
| 700 | 1 | |a Dineen, Sean P |e verfasserin |4 aut | |
| 700 | 1 | |a Powers, Benjamin D |e verfasserin |4 aut | |
| 700 | 1 | |a Veerapong, Jula |e verfasserin |4 aut | |
| 700 | 1 | |a Baumgartner, Joel M |e verfasserin |4 aut | |
| 700 | 1 | |a Clarke, Callisia N |e verfasserin |4 aut | |
| 700 | 1 | |a Patel, Sameer H |e verfasserin |4 aut | |
| 700 | 1 | |a Lambert, Laura A |e verfasserin |4 aut | |
| 700 | 1 | |a Abbott, Daniel E |e verfasserin |4 aut | |
| 700 | 1 | |a Vande Walle, Kara A |e verfasserin |4 aut | |
| 700 | 1 | |a Raoof, Mustafa |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Byrne |e verfasserin |4 aut | |
| 700 | 1 | |a Maithel, Shishir K |e verfasserin |4 aut | |
| 700 | 1 | |a Staley, Charles A |e verfasserin |4 aut | |
| 700 | 1 | |a Johnston, Fabian M |e verfasserin |4 aut | |
| 700 | 1 | |a Greer, Jonathan B |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Annals of surgical oncology |d 1995 |g 28(2021), 8 vom: 28. Aug., Seite 4499-4507 |w (DE-627)NLM074734997 |x 1534-4681 |7 nnns |
| 773 | 1 | 8 | |g volume:28 |g year:2021 |g number:8 |g day:28 |g month:08 |g pages:4499-4507 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1245/s10434-020-09501-7 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 28 |j 2021 |e 8 |b 28 |c 08 |h 4499-4507 | ||