Abstract
Background
Intraoperative blood product transfusions carry risk but are often necessary in emergency
general surgery (EGS).
Methods
We queried the American College of Surgery-National Surgical Quality Improvement Program
database for EGS patients (2008 to 2012) at 2 tertiary academic hospitals. Outcomes
included rates of high packed red blood cell (pRBC) use (estimated blood loss:pRBC
< 350:1) and high fresh frozen plasma (FFP) use (FFP:pRBC >1:1.5). Patients were then
stratified by exposure to high blood product use. Stepwise logistic regression was
performed.
Results
Of 992 patients, 33% underwent EGS. Estimated blood loss was similar between EGS and
non-EGS (282 vs 250 cc, P = .288). EGS patients were more often exposed to high pRBC use (adjusted odds ratio
[OR] = 2.01, 95% confidence interval [CI] = 1.11 to 3.66) and high-FFP use (OR = 2.75,
95% CI: = 1.10 to 6.84). High blood product use was independently associated with
major nonbleeding complications (high pRBC: OR = 1.73, 95% CI = 1.04 to 2.91; high
FFP: OR = 2.15, 95% CI = 1.15 to 4.02).
Conclusions
Despite similar blood loss, EGS patients received higher rates of intraoperative blood
product transfusion, which was independently associated with major complication.
Keywords
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Article info
Publication history
Published online: January 08, 2016
Received in revised form:
November 12,
2015
Received:
May 16,
2015
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2016 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
