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J Surg Res. 2017 Aug;216:129-137. doi: 10.1016/j.jss.2017.04.025. Epub 2017 May 5.

Perioperative blood transfusion and complications in children undergoing surgery for solid tumors.

Author information

1
Center for Surgical Outcomes Research, Nationwide Children's Hospital, Columbus, Ohio.
2
The Ohio State University College of Medicine, Columbus, Ohio.
3
Center for Surgical Outcomes Research, Nationwide Children's Hospital, Columbus, Ohio; Department of Surgery, Division of Pediatric Surgery, The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, Ohio.
4
Department of Surgery, Division of Pediatric Surgery, The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, Ohio. Electronic address: jennifer.aldrink@nationwidechildrens.org.

Abstract

BACKGROUND:

The objective was to assess whether perioperative blood transfusion (PBT) is associated with postoperative complications in children undergoing surgery for a solid tumor.

METHODS:

Using 2012-2014 National Surgical Quality Improvement Program Pediatric data, we identified patients aged 0-18 years who underwent surgery (biopsy or resection) for solid tumors. We compared demographic, clinical, and 30-day outcome characteristics between children who did and did not receive a PBT within 72 hours after surgery. Propensity score-matched analyses were used to estimate the effect of PBT on postoperative complications, in the overall cohort, the subgroup undergoing resection, and the subgroup with liver tumors.

RESULTS:

Of 961 patients who underwent surgery for solid tumors, 27.8% required PBT. Patients requiring PBT were more likely to have preoperative risk factors, including ventilator dependence, hematologic disorders, chemotherapy, sepsis, transfusion before surgery, and an American Society of Anesthesiologists class ≥3 (all P ≤ 0.01). In propensity score-matched analyses, PBT was not associated with overall complication risk (odds ratio [OR]: 1.50, P = 0.07) but was associated with an increased risk of postoperative mechanical ventilation (OR: 3.78, P < 0.001). Of the 750 patients undergoing tumor resection, 36.3% required PBT. After propensity matching, PBT was associated with overall postoperative complications (OR: 1.76, P = 0.02). Of 163 patients with liver tumors, 52.8% required PBT. After propensity matching, PBT was not associated with postoperative complications (OR: 2.00, P = 0.09). PBT was associated with a longer postoperative length of stay in all three analyses (all P < 0.01).

CONCLUSIONS:

PBT was associated with higher risks for postoperative complications in children undergoing surgery for solid tumors.

KEYWORDS:

Child; Complication; Liver; Pediatrics; Transfusion; Tumor

PMID:
28807197
DOI:
10.1016/j.jss.2017.04.025
[Indexed for MEDLINE]

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