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Peri-operative allogeneic blood transfusion and outcomes after radical cystectomy: a population-based study.
Siemens, D Robert; Jaeger, Melanie T; Wei, Xuejiao; Vera-Badillo, Francisco; Booth, Christopher M.
Afiliación
  • Siemens DR; Department of Urology, Kingston General Hospital, Queen's University, Victory 4, 76 Stuart St., Kingston, ON, K7L 2V7, Canada. siemensr@kgh.kari.net.
  • Jaeger MT; Department of Oncology, Queen's University, Kingston, Canada. siemensr@kgh.kari.net.
  • Wei X; Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Canada.
  • Vera-Badillo F; Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Kingston, Canada.
  • Booth CM; Department of Oncology, Queen's University, Kingston, Canada.
World J Urol ; 35(9): 1435-1442, 2017 Sep.
Article en En | MEDLINE | ID: mdl-28213861
INTRODUCTION: To describe factors associated with peri-operative blood transfusion (PBT) at radical cystectomy (RC) for patients with bladder cancer and evaluate its association on both early and late outcomes. METHODS: Electronic records of treatment and surgical pathology reports were linked to the population-based Ontario Cancer Registry to identify all patients who underwent RC between 2000 and 2008. Modified Poisson regression model was used to determine the factors associated with PBT. A Cox-proportional hazards regression model was used to explore the association between PBT and overall (OS) and cancer-specific (CSS) survival. RESULTS: Among 2593 patients identified, 62% received an allogeneic red blood cell transfusion. The frequency of PBT decreased over the study period (from 68 to 54%, p < 0.001). Factors associated with PBT included age, sex, greater co-morbidity, stage, and surgeon volume. PBT was associated with inferior outcomes, including median length of stay (11 vs. 9 days, p < 0.001), 90-day re-admission rate (38 vs. 29%, p < 0.001), and mortality (11 vs. 4%, p < 0.001). OS and CSS at 5 years were lower among patients with PBT on multivariate analysis (OS HR 1.33, 95% CI 1.20-1.48; CSS HR 1.39, 95% CI 1.23-1.56). CONCLUSIONS: Although rates are decreasing, these data suggest a very high utilization rate of PBT at time of RC in routine clinical practice. PBT is associated with substantially worse early outcomes and long-term survival. This association persists despite adjustment for disease-, patient-, and provider-related factors, suggesting that PBT is an important indicator of surgical care of RC.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Vejiga Urinaria / Carcinoma de Células Transicionales / Cistectomía / Transfusión de Eritrocitos / Anemia Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: World J Urol Año: 2017 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Vejiga Urinaria / Carcinoma de Células Transicionales / Cistectomía / Transfusión de Eritrocitos / Anemia Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: World J Urol Año: 2017 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Alemania