Perioperative blood transfusion in major abdominal cancer surgery: a multi-centre service evaluation and national survey.
McCullagh, Iain J Begum, Salma Patel, Akshaykumar Gillies, Michael A Bhangu, Sonia
McCullagh, Iain J
Begum, Salma
Patel, Akshaykumar
Gillies, Michael A
Bhangu, Sonia
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2022-08-23
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Abstract
In this prospective cohort study, data were collected on 412 patients undergoing surgery for intrabdominal malignancy in 14 NHS hospitals. Twenty-two (5.2%) patients received preoperative, 42 (10.2%) intraoperative, and 52 (12.2%) postoperative red blood cell transfusion. The mean postoperative transfusion trigger was 75.3 g L-1, and the mean number of units of red blood cells transfused was 1.5 (standard deviation, 1.1). Seventeen (4.0%) patients had a documented postoperative troponin elevation. Five (1.2%) patients died within 30 days of surgery. In the survey, 117 clinicians submitted complete responses, of whom 62 (53%) indicated that a transfusion threshold of 70 g L-1 was appropriate: however, this decreased to six (5.1%) if there was evidence of recent cardiac ischaemia. There were 100 (86%) respondents who indicated equipoise for a trial of restrictive vs liberal transfusion, decreasing to 56% if there was coexisting cardiovascular disease.
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McCullagh IJ, Begum S, Patel A, Gillies MA; UK Perioperative Medicine Clinical Trials Network Trial Development Group. Perioperative blood transfusion in major abdominal cancer surgery: a multi-centre service evaluation and national survey. BJA Open. 2022 Aug 23;3:100032. doi: 10.1016/j.bjao.2022.100032.
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