PT  - JOURNAL ARTICLE
AU  - Maryam Elmi
AU  - Alyson Mahar
AU  - Daniel Kagedan
AU  - Calvin H.L. Law
AU  - Paul J. Karanicolas
AU  - Yulia Lin
AU  - Jeannie Callum
AU  - Natalie G. Coburn
AU  - Julie Hallet
TI  - The impact of blood transfusion on perioperative outcomes following gastric cancer resection: an analysis of the American College of Surgeons National Surgical Quality Improvement Program database
AID  - 10.1503/cjs.004016
DP  - 2016 Oct 01
TA  - Canadian Journal of Surgery
PG  - 322--329
VI  - 59
IP  - 5
4099  - http://canjsurg.ca/content/59/5/322.short
4100  - http://canjsurg.ca/content/59/5/322.full
SO  - CAN J SURG2016 Oct 01; 59
AB  - Background: Red blood cell transfusions (RBCT) carry risk of transfusion-related immunodulation that may impact postoperative recovery. This study examined the association between perioperative RBCT and short-term postoperative outcomes following gastrectomy for gastric cancer.Methods: Using the American College of Surgeons National Surgical Quality Improvement Program database, we compared outcomes of patients (transfused v. nontransfused) undergoing elective gastrectomy for gastric cancer (2007–2012). Outcomes were 30-day major morbidity, mortality and length of stay. The association between perioperative RBCT and outcomes was estimated using modified Poisson, logistic, or negative binomial regression.Results: Of the 3243 patients in the entire cohort, we included 2884 patients with nonmissing data, of whom 535 (18.6%) received RBCT. Overall 30-day major morbidity and mortality were 20% and 3.5%, respectively. After adjustment for baseline and clinical characteristics, RBCT was independently associated with increased 30-day mortality (relative risk [RR] 3.1, 95% confidence interval [CI] 1.9–5.0), major morbidity (RR 1.4, 95% CI 1.2–1.8), length of stay (RR 1.2, 95% CI 1.1–1.2), infections (RR 1.4, 95% CI 1.1–1.6), cardiac complications (RR 1.8, 95% CI 1.0–3.2) and respiratory failure (RR 2.3, 95% CI 1.6–3.3).Conclusion: Red blood cell transfusions are associated with worse postoperative short-term outcomes in patients with gastric cancer. Blood management strategies are needed to reduce the use of RBCT after gastrectomy for gastric cancer.