Transfusion in Radical Cystectomy Increases Overall Morbidity and Mortality: A Retrospective Study Using Data from the American College of Surgeons—National Surgical Quality Improvement Program
Background: Radical cystectomy is a complex procedure imposing significant post-operation complications. Objective: Explore the impact of peri-operative pRBC transfusion on mortality and overall morbidity in a matched cohort. Methods: The American College of Surgeons—National Surgical Quality Improv...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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The Société Internationale d’Urologie (SIU)
2024-02-01
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| Series: | Société Internationale d’Urologie Journal |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2563-6499/5/1/8 |
| _version_ | 1797297038904262656 |
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| author | Christian H. Ayoub Nassib F. Abou Heidar Alexandre K. Armache Elia Abou Chawareb Albert El Hajj |
| author_facet | Christian H. Ayoub Nassib F. Abou Heidar Alexandre K. Armache Elia Abou Chawareb Albert El Hajj |
| author_sort | Christian H. Ayoub |
| collection | DOAJ |
| description | Background: Radical cystectomy is a complex procedure imposing significant post-operation complications. Objective: Explore the impact of peri-operative pRBC transfusion on mortality and overall morbidity in a matched cohort. Methods: The American College of Surgeons—National Surgical Quality Improvement Program’s (ACS-NSQIP) dataset was used to select patients who underwent RC in 2008–2019. Patients who witnessed pre-operative transfusion and emergency cases were excluded. Peri-operative pRBC transfusion was defined as an intra-operative or up to 24-h post-operative pRBC transfusion. We matched patients who underwent peri-operative pRBC transfusion to patients who did not receive transfusion. Length of stay, mortality, and overall morbidity were compared between the two matched cohorts. Results: The match cohort was matched on all pre-operative demographics and medical history variables and yielded 3578 matched patients. Patients who underwent peri-operative pRBC transfusion had a longer length of hospital stay (9.3 days) as compared to patients who did not undergo transfusion (8.13 days) (<i>p</i> < 0.001). Furthermore, patients who underwent transfusion also had higher odds of mortality (OR = 1.934) and overall morbidity (OR = 1.443) (<i>p</i> < 0.03). Specifically, patients who underwent transfusion had higher odds of organ space SSI, pneumonia, unplanned intubation, pulmonary embolism, failure to wean off of ventilator, renal insufficiency, urinary tract infections, stroke, myocardial infarction, cardiac arrest requiring CPR, deep vein thrombosis, and septic shock (<i>p</i> < 0.047). Conclusion: Peri-operative pRBC transfusion in RC was associated with longer hospital stays, significant morbidity, and mortality. For this reason, pre-operative patient optimization and possible alternatives to common pRBC practices should be considered in RC to circumvent complications. |
| first_indexed | 2024-03-07T22:14:29Z |
| format | Article |
| id | doaj.art-ecd3ba7abaf1433dbe5b7433958fa252 |
| institution | Directory Open Access Journal |
| issn | 2563-6499 |
| language | English |
| last_indexed | 2024-03-07T22:14:29Z |
| publishDate | 2024-02-01 |
| publisher | The Société Internationale d’Urologie (SIU) |
| record_format | Article |
| series | Société Internationale d’Urologie Journal |
| spelling | doaj.art-ecd3ba7abaf1433dbe5b7433958fa2522024-02-23T15:34:21ZengThe Société Internationale d’Urologie (SIU)Société Internationale d’Urologie Journal2563-64992024-02-0151425010.3390/siuj5010008Transfusion in Radical Cystectomy Increases Overall Morbidity and Mortality: A Retrospective Study Using Data from the American College of Surgeons—National Surgical Quality Improvement ProgramChristian H. Ayoub0Nassib F. Abou Heidar1Alexandre K. Armache2Elia Abou Chawareb3Albert El Hajj4Department of Surgery, Division of Urology, American University of Beirut Medical Center, Riad El Solh, P.O. Box 11-0236, Beirut 1107 2020, LebanonDepartment of Surgery, Division of Urology, American University of Beirut Medical Center, Riad El Solh, P.O. Box 11-0236, Beirut 1107 2020, LebanonDepartment of Surgery, Division of Urology, American University of Beirut Medical Center, Riad El Solh, P.O. Box 11-0236, Beirut 1107 2020, LebanonDepartment of Surgery, Division of Urology, American University of Beirut Medical Center, Riad El Solh, P.O. Box 11-0236, Beirut 1107 2020, LebanonDepartment of Surgery, Division of Urology, American University of Beirut Medical Center, Riad El Solh, P.O. Box 11-0236, Beirut 1107 2020, LebanonBackground: Radical cystectomy is a complex procedure imposing significant post-operation complications. Objective: Explore the impact of peri-operative pRBC transfusion on mortality and overall morbidity in a matched cohort. Methods: The American College of Surgeons—National Surgical Quality Improvement Program’s (ACS-NSQIP) dataset was used to select patients who underwent RC in 2008–2019. Patients who witnessed pre-operative transfusion and emergency cases were excluded. Peri-operative pRBC transfusion was defined as an intra-operative or up to 24-h post-operative pRBC transfusion. We matched patients who underwent peri-operative pRBC transfusion to patients who did not receive transfusion. Length of stay, mortality, and overall morbidity were compared between the two matched cohorts. Results: The match cohort was matched on all pre-operative demographics and medical history variables and yielded 3578 matched patients. Patients who underwent peri-operative pRBC transfusion had a longer length of hospital stay (9.3 days) as compared to patients who did not undergo transfusion (8.13 days) (<i>p</i> < 0.001). Furthermore, patients who underwent transfusion also had higher odds of mortality (OR = 1.934) and overall morbidity (OR = 1.443) (<i>p</i> < 0.03). Specifically, patients who underwent transfusion had higher odds of organ space SSI, pneumonia, unplanned intubation, pulmonary embolism, failure to wean off of ventilator, renal insufficiency, urinary tract infections, stroke, myocardial infarction, cardiac arrest requiring CPR, deep vein thrombosis, and septic shock (<i>p</i> < 0.047). Conclusion: Peri-operative pRBC transfusion in RC was associated with longer hospital stays, significant morbidity, and mortality. For this reason, pre-operative patient optimization and possible alternatives to common pRBC practices should be considered in RC to circumvent complications.https://www.mdpi.com/2563-6499/5/1/8blood transfusioncystectomysurgical oncologyurinary bladder neoplasmsurology |
| spellingShingle | Christian H. Ayoub Nassib F. Abou Heidar Alexandre K. Armache Elia Abou Chawareb Albert El Hajj Transfusion in Radical Cystectomy Increases Overall Morbidity and Mortality: A Retrospective Study Using Data from the American College of Surgeons—National Surgical Quality Improvement Program Société Internationale d’Urologie Journal blood transfusion cystectomy surgical oncology urinary bladder neoplasms urology |
| title | Transfusion in Radical Cystectomy Increases Overall Morbidity and Mortality: A Retrospective Study Using Data from the American College of Surgeons—National Surgical Quality Improvement Program |
| title_full | Transfusion in Radical Cystectomy Increases Overall Morbidity and Mortality: A Retrospective Study Using Data from the American College of Surgeons—National Surgical Quality Improvement Program |
| title_fullStr | Transfusion in Radical Cystectomy Increases Overall Morbidity and Mortality: A Retrospective Study Using Data from the American College of Surgeons—National Surgical Quality Improvement Program |
| title_full_unstemmed | Transfusion in Radical Cystectomy Increases Overall Morbidity and Mortality: A Retrospective Study Using Data from the American College of Surgeons—National Surgical Quality Improvement Program |
| title_short | Transfusion in Radical Cystectomy Increases Overall Morbidity and Mortality: A Retrospective Study Using Data from the American College of Surgeons—National Surgical Quality Improvement Program |
| title_sort | transfusion in radical cystectomy increases overall morbidity and mortality a retrospective study using data from the american college of surgeons national surgical quality improvement program |
| topic | blood transfusion cystectomy surgical oncology urinary bladder neoplasms urology |
| url | https://www.mdpi.com/2563-6499/5/1/8 |
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