Blood loss and transfusion in elective abdominal aortic aneurysm surgery.
BACKGROUND
Intraoperative blood loss and transfusion are known determinants of mortality and morbidity of elective abdominal aortic aneurysm (AAA) repair. The present study analysed the pattern of blood loss and transfusion and evaluated the risk factors of blood loss during open repair of infrarenal AAA.


METHODS
Blood loss, transfusion and fluid replacement during elective open repair operation for patients with infrarenal AAA were correlated to demographic data, operative findings and procedural information.


RESULTS
A total of 129 patients with a mean age of 71 years was analysed. The mean blood loss was 1000 +/- 887 mL (200-6000 mL). Blood transfusion, with a mean transfusion volume of 400 +/- 591 mL (0-3000 mL), was required in 46% of patients. Univariate analysis showed that bodyweight, renal impairment, low haemoglobin and platelet counts, iliac artery involvement, large aneurysm, bifurcated graft, large graft diameter, prolonged aortic clamp time and long operation time were associated with a higher blood loss. A haemoglobin level of <10.5 g/dL (relative risk (RR): 4.6), platelet count <130 x 10(9)/L (RR: 3.9), aortic clamp time >50 min (RR: 15), total operation time >200 min (RR: 11) and type of graft (RR: 3.5) were identified as independent determinants of blood loss on multivariate analysis.


CONCLUSIONS
Intraoperative blood loss in elective infrarenal aneurysm surgery is influenced by patients' haematological parameters, distal involvement of aneurysm and degree of difficulty of operation.
Division of Vascular Surgery, Department of Surgery, Queen Mary Hospital, University of Hong Kong Medical Centre, Hong Kong.
Pei
P
Ho
Albert C W
AC
Ting
Stephen W K
SW
Cheng
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D001810:Blood Volume; D017558:Elective Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors