Predictors for Perioperative Blood Transfusion in Patients Undergoing Open Cystectomy and Urinary Diversion and Development of a Nomogram: An Observational Cohort Study.

Engel, Dominique; Beilstein, Christian M.; Jerney, Pascal; Furrer, Marc A; Burkhard, Fiona C.; Löffel, Lukas M.; Wuethrich, Patrick Y. (2021). Predictors for Perioperative Blood Transfusion in Patients Undergoing Open Cystectomy and Urinary Diversion and Development of a Nomogram: An Observational Cohort Study. Journal of clinical medicine, 10(13) MDPI 10.3390/jcm10132797

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Open radical cystectomy is associated with a substantial rate of perioperative blood transfusion. Early detection of potentially modifiable perioperative factors could reduce the need for perioperative blood transfusion and thus positively impact the outcome. We conducted an observational, single-center cohort study of 1168 patients undergoing cystectomy. Perioperative blood transfusion was defined as the need for packed red blood cells and/or fresh frozen plasma units within the first 24 h after the initiation of surgery. Multiple logistic regression analysis was performed to model the association between risk factors and blood transfusion, and a nomogram was developed. Blood transfusion occurred in 370/1168 patients (31.7%). Significant predictors were age (OR: 1.678, (95% CI: 1.379-2.042); p < 0.001), blood loss ratio (6.572, (4.878-8.853); p < 0.001), preoperative hemoglobin (0.316, (0.255-0.391); p < 0.001), tumor stage (2.067, (1.317-3.244); p = 0.002), use of oral anticoagulants (2.70, (1.163-6.270), p = 0.021), and interaction between female sex and blood loss ratio (1.344, (1.011-1.787); p = 0.042). Of the major predictors found to affect perioperative blood transfusion, two can be influenced: blood loss ratio by meticulous surgery and hemoglobin by preoperative optimization. Others such as age or advanced disease are not modifiable. This emphasizes the importance of optimal management of patients prior to surgery.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Urology

UniBE Contributor:

Engel, Dominique; Beilstein, Christian; Jerney, Pascal; Burkhard, Fiona Christine; Löffel, Lukas and Wüthrich, Patrick Yves

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2077-0383

Publisher:

MDPI

Language:

English

Submitter:

Andrea Stettler

Date Deposited:

14 Jul 2021 10:07

Last Modified:

14 Jul 2021 10:11

Publisher DOI:

10.3390/jcm10132797

PubMed ID:

34202030

Uncontrolled Keywords:

blood transfusion cystectomy predictors

BORIS DOI:

10.48350/157552

URI:

https://boris.unibe.ch/id/eprint/157552

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