Janina V Pearce, Jinlei Zhao, Leslie Randall, Stephanie A Sullivan, Devin Miller, Katherine Tossas
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There were significant differences in EBL and preoperative hemoglobin levels between patients who did and did not receive transfusion (EBL 442.6 vs 236.8 mL, <i>P</i> = 0.0008; preoperative hemoglobin 10.2 vs 11.2 g/dL, <i>P</i> = 0.049). After adjusting for preoperative hemoglobin, the risk of transfusion increased for each additional 200 mL of EBL (odds ratio [OR] 3.8, 95% confidence interval [CI] 1.5-9.5). Stratified by race, the association between EBL and transfusion risk remained statistically significant only for non-Latinx White patients (OR 6.1, 95% CI 1.7-21.9), who made up 77% of the study population, but not for patients of other races and ethnicities (OR 1.0, 95% CI 0.16-6.42).</p><p><strong>Conclusions: </strong>Perioperative blood transfusion is common in patients undergoing cytoreductive surgery. In this study, EBL and preoperative hemoglobin levels were significantly associated with transfusion receipt. Clinicians should optimize hemoglobin levels and intraoperative blood conservation strategies to reduce the need for transfusion. The results also highlight the importance of considering racial and ethnic differences when developing strategies to reduce transfusion risk.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.0000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11073803/pdf/","citationCount":"0","resultStr":"{\"title\":\"Predictors of Blood Transfusion in Patients Undergoing Cytoreductive Surgeries for Ovarian Malignancy.\",\"authors\":\"Janina V Pearce, Jinlei Zhao, Leslie Randall, Stephanie A Sullivan, Devin Miller, Katherine Tossas\",\"doi\":\"10.14423/SMJ.0000000000001685\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>The aims of this study were to describe the baseline estimated blood loss (EBL) in surgery and transfusion rate in patients undergoing cytoreductive surgeries for ovarian malignancy, and identify perioperative variables associated with blood loss and transfusion.</p><p><strong>Methods: </strong>A retrospective cohort study at a single institution was performed that included patients with known or suspected ovarian malignancy undergoing cytoreductive surgery between 2016 and 2021. <i>t</i> tests, χ<sup>2</sup> tests, and multiple logistic regression analyses were used.</p><p><strong>Results: </strong>Among 44 patients meeting inclusion criteria, 61% received perioperative blood transfusion. 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引用次数: 0
摘要
研究目的本研究旨在描述因卵巢恶性肿瘤接受细胞减灭术的患者在手术中的基线估计失血量(EBL)和输血率,并确定与失血和输血相关的围手术期变量:方法:在一家机构进行了一项回顾性队列研究,纳入了2016年至2021年期间接受囊肿剥除手术的已知或疑似卵巢恶性肿瘤患者,采用t检验、χ2检验和多元逻辑回归分析:在44名符合纳入标准的患者中,61%接受了围手术期输血。接受和未接受输血的患者在 EBL 和术前血红蛋白水平上存在明显差异(EBL 442.6 vs 236.8 mL,P = 0.0008;术前血红蛋白 10.2 vs 11.2 g/dL,P = 0.049)。调整术前血红蛋白后,EBL 每增加 200 毫升,输血风险就会增加(几率比 [OR] 3.8,95% 置信区间 [CI] 1.5-9.5)。按种族分层,EBL 与输血风险之间的关系仅对占研究人群 77% 的非拉丁裔白人患者有统计学意义(OR 6.1,95% CI 1.7-21.9),而对其他种族和民族的患者则没有意义(OR 1.0,95% CI 0.16-6.42):结论:围手术期输血在接受细胞再生手术的患者中很常见。本研究中,EBL 和术前血红蛋白水平与接受输血显著相关。临床医生应优化血红蛋白水平和术中血液保存策略,以减少输血需求。研究结果还强调了在制定降低输血风险的策略时考虑种族和民族差异的重要性。
Predictors of Blood Transfusion in Patients Undergoing Cytoreductive Surgeries for Ovarian Malignancy.
Objectives: The aims of this study were to describe the baseline estimated blood loss (EBL) in surgery and transfusion rate in patients undergoing cytoreductive surgeries for ovarian malignancy, and identify perioperative variables associated with blood loss and transfusion.
Methods: A retrospective cohort study at a single institution was performed that included patients with known or suspected ovarian malignancy undergoing cytoreductive surgery between 2016 and 2021. t tests, χ2 tests, and multiple logistic regression analyses were used.
Results: Among 44 patients meeting inclusion criteria, 61% received perioperative blood transfusion. There were significant differences in EBL and preoperative hemoglobin levels between patients who did and did not receive transfusion (EBL 442.6 vs 236.8 mL, P = 0.0008; preoperative hemoglobin 10.2 vs 11.2 g/dL, P = 0.049). After adjusting for preoperative hemoglobin, the risk of transfusion increased for each additional 200 mL of EBL (odds ratio [OR] 3.8, 95% confidence interval [CI] 1.5-9.5). Stratified by race, the association between EBL and transfusion risk remained statistically significant only for non-Latinx White patients (OR 6.1, 95% CI 1.7-21.9), who made up 77% of the study population, but not for patients of other races and ethnicities (OR 1.0, 95% CI 0.16-6.42).
Conclusions: Perioperative blood transfusion is common in patients undergoing cytoreductive surgery. In this study, EBL and preoperative hemoglobin levels were significantly associated with transfusion receipt. Clinicians should optimize hemoglobin levels and intraoperative blood conservation strategies to reduce the need for transfusion. The results also highlight the importance of considering racial and ethnic differences when developing strategies to reduce transfusion risk.
期刊介绍:
As the official journal of the Birmingham, Alabama-based Southern Medical Association (SMA), the Southern Medical Journal (SMJ) has for more than 100 years provided the latest clinical information in areas that affect patients'' daily lives. Now delivered to individuals exclusively online, the SMJ has a multidisciplinary focus that covers a broad range of topics relevant to physicians and other healthcare specialists in all relevant aspects of the profession, including medicine and medical specialties, surgery and surgery specialties; child and maternal health; mental health; emergency and disaster medicine; public health and environmental medicine; bioethics and medical education; and quality health care, patient safety, and best practices. Each month, articles span the spectrum of medical topics, providing timely, up-to-the-minute information for both primary care physicians and specialists. Contributors include leaders in the healthcare field from across the country and around the world. The SMJ enables physicians to provide the best possible care to patients in this age of rapidly changing modern medicine.