title: Intraoperative transfusion of packed red blood cells in microvascular free tissue transfer patients: assessment of 30-day morbidity using the NSQIP dataset.
abstract: Although often a life-saving therapeutic maneuver, there is minimal data available that details the effects of intraoperative packed red blood cell transfusion (IOT) after microvascular free tissue transfer. The National Surgical Quality Improvement Program database was queried to identify all patients who underwent microvascular free tissue transfer between 2006 and 2010. Multivariate logistic regression models were used to determine the association between intraoperative transfusion and outcomes. Upon bivariate and multivariate analyses, IOT was significantly associated with higher rates of overall complications (odds ratio [OR], 2.02; 95% confidence interval [CI], 1.12-3.63), medical complications (OR, 3.35; 95% CI, 1.75-6.42), postoperative transfusion (OR, 6.02; 95% CI, 2.02-17.97), and reoperation (OR, 2.24; 95% CI, 1.24-4.04). IOT was not associated with either surgical complications or free flap loss. IOT significantly increases risk for adverse overall and medical complications. However, IOT was not associated with surgical complications or free flap loss. Transfusion practices in the operating room should be reevaluated to improve overall outcomes.
authors.affiliation: Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois.
authors.forename: Bobby D
authors.initials: BD
authors.lastname: Kim
authors.affiliation: Department of Plastic Surgery, Health Science Center, University of Tennessee, Memphis, Tennessee.
authors.forename: Jon P
authors.initials: JP
authors.lastname: Ver Halen
authors.affiliation: Division of Plastic and Reconstructive Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Alexei S
authors.initials: AS
authors.lastname: Mlodinow
authors.affiliation: Division of Plastic and Reconstructive Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: John Y S
authors.initials: JY
authors.lastname: Kim
mesh_terms: D001803:Blood Transfusion / Q000379:methods / Q000401:mortality; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D007431:Intraoperative Complications / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011183:Postoperative Complications / Q000401:mortality / Q000628:therapy*; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods / Q000401:mortality