title: Perioperative blood transfusion practices in oncologic thoracic surgery: when, why, and how.
abstract: BACKGROUND
  Available information on perioperative blood transfusion practices in oncologic thoracic surgery is scant and outdated. The purpose of this study was to investigate transfusion requirements in patients undergoing curative resection for lung cancer and to identify possible factors predictive of perioperative blood transfusion in our cohort of patients.
  
  
  METHODS
  From 1st January 2009 to 31st December 2009, 317 patients underwent anatomic pulmonary resection. Patients who received at least 1 unit of red blood cells comprised the "transfused" group. Each case in this group was matched for surgical procedure with a control subject who did not require blood transfusion and was operated on during the same year; these patients comprised the "not transfused" group.
  
  
  RESULTS
  A total of 75 patients (23.6%) received at least 1 unit of red blood cells during the perioperative period. Factors conditioning perioperative blood transfusion were: preoperative hemoglobin level (p < 0.0001); procedure duration (p = 0.017); body mass index (p < 0.001); induction therapies (p = 0.017); redo procedure (p = 0.021). Age, sex, histology, stage, ASA score, side, intraoperative blood loss, and fluid infusion did not affect perioperative blood transfusion practices.
  
  
  CONCLUSIONS
  Preoperative hemoglobin level is the major risk factor for perioperative blood transfusion practices in oncologic thoracic surgery; procedure duration, body mass index, induction therapies, and redo procedure may condition transfusional needs, although they were actually not predictive on multivariate analysis.
authors: Department of Thoracic Surgery, European Institute of Oncology, Milan, Italy. francesco.petrella@ieo.it
authors: Francesco
authors: F
authors: Petrella
authors: Davide
authors: D
authors: Radice
authors: Maria Giovanna
authors: MG
authors: Randine
authors: Alessandro
authors: A
authors: Borri
authors: Domenico
authors: D
authors: Galetta
authors: Roberto
authors: R
authors: Gasparri
authors: Stefano
authors: S
authors: Donghi
authors: Monica
authors: M
authors: Casiraghi
authors: Adele
authors: A
authors: Tessitore
authors: Juliana
authors: J
authors: Guarize
authors: Alessandro
authors: A
authors: Pardolesi
authors: Piergiorgio
authors: P
authors: Solli
authors: Giulia
authors: G
authors: Veronesi
authors: Lorenzo
authors: L
authors: Spaggiari
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery / Q000628:therapy; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001803:Blood Transfusion; D002294:Carcinoma, Squamous Cell / Q000601:surgery / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery* / Q000628:therapy*; D008297:Male; D019990:Perioperative Care; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D019616:Thoracic Surgical Procedures