Perioperative blood transfusion in major abdominal cancer surgery: a multi-centre service evaluation and national survey

作者：Iain McCullagh, Salma Begum, Akshaykumar Patel, Michael Gillies, Thomas Abberton, Thomas E.F. Abbott, Samuel Al-Kadhimi, Thomas Anderson, Matthew J. Baker, Sonia Bhangu, Stephen Biggart, Adam Boulton, Elisabeth Brun-Lacey, Andrew Clarke, Stephen Daly, Mark Edwards, Naemeka Egbuonu, Alexander J. Fowler, James B. Hale, Ramanathan Kasivisvanathan, Rachel Jennings, Shaman Jhanji, Helen E. Jordan, Mortimer Kelleher, M S Khan, Denny Levett, Denise Lim, Thomas Medici, Malar Mani, Kirsty Mann, Christopher Parsons, Srin Perumal, Mandeep Phull, Edward N. Pugh, Tarannum Rampal, William Rook, R. C. F. Sinclair, Daniel A. Sumner, Tamás Szakmány, Tara Lal Shrestha, Gemma Timms, Abigail Ward, Joyce Yeung, Yijun Cai · 发表于：BJA Open · 年份：2022 · DOI：10.1016/j.bjao.2022.100032 · 被引用次数：9 · 研究领域：Blood transfusion and management、Cardiac, Anesthesia and Surgical Outcomes、Erythropoietin and Anemia Treatment

Anaemia is associated with complications and death after surgery. Perioperative red-cell transfusion triggers are not well defined in patients having oncological surgery, or with cardiovascular disease. We carried out a prospective multicentre cohort study and a clinician survey of UK transfusion practice in adult patients undergoing surgery for abdominal malignancy. The primary outcome was red cell transfusion. Secondary outcomes were transfusion trigger haemoglobin, incidence of complications, length of hospital stay, and acute hospital mortality. In this prospective cohort study, data were collected on 412 patients undergoing surgery for intrabdominal malignancy in 14 NHS hospitals. Twenty-two (5.2%) patients received preoperative, 42 (10.2%) intraoperative, and 52 (12.2%) postoperative red blood cell transfusion. The mean postoperative transfusion trigger was 75.3 g L−1, and the mean number of units of red blood cells transfused was 1.5 (standard deviation, 1.1). Seventeen (4.0%) patients had a documented postoperative troponin elevation. Five (1.2%) patients died within 30 days of surgery. In the survey, 117 clinicians submitted complete responses, of whom 62 (53%) indicated that a transfusion threshold of 70 g L−1 was appropriate: however, this decreased to six (5.1%) if there was evidence of recent cardiac ischaemia. There were 100 (86%) respondents who indicated equipoise for a trial of restrictive vs liberal transfusion, decreasing to 56% if there was coexisting card...