{"title":"肝硬化退伍军人术中输血的预测因素和结果","authors":"Awni Shahait, Adam Pearl, K. Saleh","doi":"10.58877/japaj.v1i2.33","DOIUrl":null,"url":null,"abstract":"Background: Cirrhotic patients are at increased risk of postoperative complications and mortality following any surgical procedure. One of the independent predators of adverse outcomes is intraoperative transfusion (IOT). In this study we examine the profile of cirrhotic patients requiring IOT to determine its predictors. \nMethods: The Veterans Affairs Surgical Quality Improvement Program (VASQIP) was utilized to identify all patients with cirrhosis and ascites who underwent any non-liver transplant procedures from 2008 to 2015. Univariate and multivariate regression were used to identify predictors of increased risk of IOT and associated outcomes. \nResults: A total of 1,957 cirrhotic patients were identified, of which only 358 (18.8%) required IOT ≥1 unit. IOT group were older, more frail, higher Model for End-stage Liver Disease (MELD) score, anemic (hematocrit <30%), hypoalbuminemic. This group also had more emergent procedures, higher rates of preoperative sepsis, longer operative time, longer postoperative length of stay, and higher morbidity and mortality rates. On multivariate logistic regression, pancreatic resections, open hernia repair, anemia, gastric resections, hypoalbuminemia, acute renal failure, emergency procedure, preoperative sepsis, and preoperative weight loss >10% were significant predictors of IOT. \nConclusion: IOT in cirrhotic patients is associated with worse outcomes. Pancreatic procedures, open hernia repair, and gastric resection were associated with increased IOT. This aid in preoperative planning and blood products preparation. ","PeriodicalId":364383,"journal":{"name":"JAP Academy Journal","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Predictors and Outcomes of Intraoperative Blood Transfusion in Cirrhotic Veterans\",\"authors\":\"Awni Shahait, Adam Pearl, K. Saleh\",\"doi\":\"10.58877/japaj.v1i2.33\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Cirrhotic patients are at increased risk of postoperative complications and mortality following any surgical procedure. One of the independent predators of adverse outcomes is intraoperative transfusion (IOT). In this study we examine the profile of cirrhotic patients requiring IOT to determine its predictors. \\nMethods: The Veterans Affairs Surgical Quality Improvement Program (VASQIP) was utilized to identify all patients with cirrhosis and ascites who underwent any non-liver transplant procedures from 2008 to 2015. Univariate and multivariate regression were used to identify predictors of increased risk of IOT and associated outcomes. \\nResults: A total of 1,957 cirrhotic patients were identified, of which only 358 (18.8%) required IOT ≥1 unit. IOT group were older, more frail, higher Model for End-stage Liver Disease (MELD) score, anemic (hematocrit <30%), hypoalbuminemic. This group also had more emergent procedures, higher rates of preoperative sepsis, longer operative time, longer postoperative length of stay, and higher morbidity and mortality rates. On multivariate logistic regression, pancreatic resections, open hernia repair, anemia, gastric resections, hypoalbuminemia, acute renal failure, emergency procedure, preoperative sepsis, and preoperative weight loss >10% were significant predictors of IOT. \\nConclusion: IOT in cirrhotic patients is associated with worse outcomes. Pancreatic procedures, open hernia repair, and gastric resection were associated with increased IOT. This aid in preoperative planning and blood products preparation. \",\"PeriodicalId\":364383,\"journal\":{\"name\":\"JAP Academy Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-06-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JAP Academy Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.58877/japaj.v1i2.33\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JAP Academy Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.58877/japaj.v1i2.33","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Predictors and Outcomes of Intraoperative Blood Transfusion in Cirrhotic Veterans
Background: Cirrhotic patients are at increased risk of postoperative complications and mortality following any surgical procedure. One of the independent predators of adverse outcomes is intraoperative transfusion (IOT). In this study we examine the profile of cirrhotic patients requiring IOT to determine its predictors.
Methods: The Veterans Affairs Surgical Quality Improvement Program (VASQIP) was utilized to identify all patients with cirrhosis and ascites who underwent any non-liver transplant procedures from 2008 to 2015. Univariate and multivariate regression were used to identify predictors of increased risk of IOT and associated outcomes.
Results: A total of 1,957 cirrhotic patients were identified, of which only 358 (18.8%) required IOT ≥1 unit. IOT group were older, more frail, higher Model for End-stage Liver Disease (MELD) score, anemic (hematocrit <30%), hypoalbuminemic. This group also had more emergent procedures, higher rates of preoperative sepsis, longer operative time, longer postoperative length of stay, and higher morbidity and mortality rates. On multivariate logistic regression, pancreatic resections, open hernia repair, anemia, gastric resections, hypoalbuminemia, acute renal failure, emergency procedure, preoperative sepsis, and preoperative weight loss >10% were significant predictors of IOT.
Conclusion: IOT in cirrhotic patients is associated with worse outcomes. Pancreatic procedures, open hernia repair, and gastric resection were associated with increased IOT. This aid in preoperative planning and blood products preparation.