title: Restrictive blood transfusion protocol in malignant upper gastrointestinal and pancreatic resections patients reduces blood transfusions with no increase in patient morbidity.
abstract: BACKGROUND
  The purpose of this study was to determine the impact of a restrictive blood transfusion protocol on the number of transfusions performed and the related effect on patient morbidity.
  
  
  METHODS
  A cohort study was performed using our prospective database with information from January 1, 2000, to June 1, 2013. The restrictive blood transfusion protocol was implemented in September 2011, so this date served as the separation point for the date of operation criteria.
  
  
  RESULTS
  For the study, 415 patients undergoing operation for an abdominal malignancy were reviewed. After the restrictive blood transfusion protocol, the percentage of patients who received blood dropped from 35.6% to 28.3%. The percentage of patients who experienced perioperative complication was significantly higher in transfused patients compared with those who did not receive blood (P = .0001). There was no statistical significance observed between the 5 groups for the length of stay at the hospital after their procedure.
  
  
  CONCLUSIONS
  The restrictive blood transfusion protocol resulted in a reduction of the percentage of patients transfused, and there was no evidence to suggest that it negatively affected the outcomes of patients in this group.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Louisville, 315 East Broadway #312, Louisville, KY, 40202, USA.
authors.forename: John
authors.initials: J
authors.lastname: Wehry
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Louisville, 315 East Broadway #312, Louisville, KY, 40202, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Agle
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Louisville, 315 East Broadway #312, Louisville, KY, 40202, USA.
authors.forename: Prejesh
authors.initials: P
authors.lastname: Philips
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Louisville, 315 East Broadway #312, Louisville, KY, 40202, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Cannon
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Louisville, 315 East Broadway #312, Louisville, KY, 40202, USA.
authors.forename: Charles R
authors.initials: CR
authors.lastname: Scoggins
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Louisville, 315 East Broadway #312, Louisville, KY, 40202, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Puffer
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Louisville, 315 East Broadway #312, Louisville, KY, 40202, USA.
authors.forename: Kelly M
authors.initials: KM
authors.lastname: McMasters
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Louisville, 315 East Broadway #312, Louisville, KY, 40202, USA. Electronic address: robert.martin@louisville.edu.
authors.forename: Robert C G
authors.initials: RC
authors.lastname: Martin
mesh_terms: D000368:Aged; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D002985:Clinical Protocols; D004067:Digestive System Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Blood transfusion; Complications; Esophagectomy; Gastrectomy; Hepatectomy; Pancreatectomy