Identification of predictive factors for perioperative blood transfusion in colorectal resection patients.
BACKGROUND
Blood transfusion is associated with higher postoperative complication. With the availability of autologous blood and erythropoietin, it would be advantageous to identify patients who are at higher risk for requiring blood transfusion. Our aim is to identify possible predictive factors for perioperative blood transfusion in patients undergoing colorectal resection. We examined 206 patients who underwent colorectal resections.


METHODS
We analyzed factors including preoperative hematocrit, age, history of radiation, type of resection, operative blood loss, additional surgical procedure, surgery duration, and comorbidity.


RESULTS
Forty-one patients (19.9%) received perioperative blood transfusion. Twenty patients (55.6%) with preoperative hematocrit less than 30 received transfusion (p<0.0001). Twenty-one patients (12.4%) with preoperative hematocrit greater than 30 received perioperative blood transfusion. Thirty-three patients (17.9%) under 65 years received transfusion. Eight patients (36.4%) more than the age of 65 received transfusion (p=0.05). Ten patients (16.1%) without any comorbidity received transfusion, whereas ten patients (15.1%) with one comorbidity, ten patients (22.2%) with two comorbidities, and 11 patients (33.3%) with greater than three comorbidities received blood transfusion (p=0.07). In the multivariate analysis, relative risk of perioperative blood transfusion was 3.63 for patients with preoperative hematocrit less than 30 (p<0.0001), 1.26 for patients more than the age of 65 (p=0.49), and 1.07 for each comorbidity (p=0.62). Patients with higher number of comorbidities and age greater than 65 tend to have lower preoperative hematocrit than other patients.


CONCLUSIONS
Hematocrit less than 30 is an independent risk factor for requiring perioperative blood transfusion, and patients with hematocrit less than 30 should be considered for autologous blood transfusion and erythropoietin.
Kim
Justin
J
Division of Colon and Rectal Surgery, Harbor-UCLA Medical Center, P.O. Box 25, Torrance, CA 90509, USA.
Konyalian
Viken
V
Huynh
Richard
R
Mittal
Raj
R
Stamos
Michael
M
Kumar
Ravin
R
D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D003106:Colon / Q000601:surgery*; D003108:Colonic Diseases / Q000097:blood / Q000601:surgery*; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006397:Hematinics / Q000627:therapeutic use*; D006400:Hematocrit; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D019990:Perioperative Care; D012002:Rectal Diseases / Q000097:blood / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors
D006397:Hematinics; D004921:Erythropoietin