Perioperative blood transfusion in gynecologic oncology surgery: analysis of the National Surgical Quality Improvement Program Database.
Perioperative blood transfusion in gynecologic oncology surgery: analysis of the National Surgical Quality Improvement Program Database.
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DOI：
10.1016/j.ygyno.2014.11.009
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发表时间：
2015-01
影响因子：
4.7
通讯作者：
Bodurka DC
中科院分区：
文献类型：
--
作者：
Prescott LS;Aloia TA;Brown AJ;Taylor JS;Munsell MF;Sun CC;Schmeler KM;Levenback CF;Bodurka DC
使用大规模的多机构数据集来量化填充红细胞输血的流行程度，并检查输血与妇科癌症手术围手术期结局之间的关系。美国外科医师学会国家外科手术质量改进计划（NSQIP）参与者使用文件查询2010 - 2012年间所有妇科癌症病例。使用卡方检验、Fisher精确检验和Wilcoxon秩和检验比较输血组和非输血组的人口学、术前和术中变量。主要终点是30天的综合发病率。次要终点包括复合手术部位感染、死亡率和住院时间。共分析了8519例患者，其中13.8%的患者接受了填充红细胞输血。在多因素分析中，在调整了关键的临床和围手术期因素（包括术前贫血和病例数量）后，输血与较高的综合发病率（OR = 1.85, 95% CI 1.5 - 2.24）、手术部位感染（OR 1.80, 95% CI 1.39 - 2.35）、死亡率（OR 3.38, 95% CI 1.80 - 6.36）和住院时间（3.02天对7.17天，p <0.001）相关。输血与外科伤口感染、综合发病率和死亡率增加有关。根据我们对NSQIP数据库的分析，妇科癌症的输血实践应该受到审查。检查妇科恶性肿瘤的机构实践和制定输血指南可能会更好地利用血库资源和改善患者的临床结果。
To use a large-scale multi-institutional dataset to quantify the prevalence of packed red blood cell transfusions and examine the associations between transfusion and perioperative outcomes in gynecologic cancer surgery. The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) participant use file was queried for all gynecologic cancer cases between 2010 and 2012. Demographic, preoperative and intraoperative variables were compared between transfusion and non-transfusion groups using chi-squared, Fisher’s exact and Wilcoxon rank-sum test. The primary endpoint was 30-day composite morbidity. Secondary endpoints included composite surgical site infections, mortality and length of stay. A total of 8,519 patients were analyzed, and 13.8% received a packed red blood cell transfusion. In the multivariate analysis, after adjusting for key clinical and perioperative factors, including preoperative anemia and case magnitude, transfusion was associated with higher composite morbidity (OR = 1.85, 95% CI 1.5 – 2.24), surgical site infections (OR 1.80, 95% CI 1.39 – 2.35), mortality (OR 3.38, 95% CI 1.80 – 6.36) and length of hospital stay (3.02 days v. 7.17 days, p <0.001). Blood transfusions are associated with increased surgical wound infections, composite morbidity and mortality. Based on our analysis of the NSQIP database, transfusion practices in gynecologic cancer should be scrutinized. Examination of institutional practices and creation of transfusion guidelines for gynecologic malignancies could potentially result in better utilization of blood bank resources and clinical outcomes among patients.
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影响因子：
4.7
作者：
Backes, Floor J.;Brudie, Lorna A.;Fowler, Jeffrey M.
通讯作者：
Fowler, Jeffrey M.
DOI：
10.1016/s0360-3016(03)00123-8
发表时间：
2003-07-01
影响因子：
7
作者：
Dunst, J;Kuhnt, T;Haensgen, G
通讯作者：
Haensgen, G
DOI：
10.1016/s0955-3886(97)90012-6
发表时间：
1997-03-01
期刊：
TRANSFUSION SCIENCE
影响因子：
--
作者：
Azuma, C;Koyama, M;Ozaki, M
通讯作者：
Ozaki, M
影响因子：
39.2
作者：
Carson, Jeffrey L.;Grossman, Brenda J.;Djulbegovic, Benjamin
通讯作者：
Djulbegovic, Benjamin
DOI：
10.1016/j.jamcollsurg.2013.05.015
发表时间：
2013-10-01
影响因子：
5.2
作者：
Merkow, Ryan P.;Bentrem, David J.;Bilimoria, Karl Y.
通讯作者：
Bilimoria, Karl Y.