Long-term outcomes of an integrated transfusion reduction initiative in patients undergoing resection for colorectal cancer

Abstract Background Perioperative blood transfusion in patients with colorectal cancer has been associated with increased cost, morbidity, mortality, and decreased survival. Five years ago, a transfusion reduction initiative (TRI) was implemented. We sought to evaluate the 5-year effectiveness and p...

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Bibliographic Details
Published in:The American journal of surgery 2015-12, Vol.210 (6), p.990-995
Main Authors: Van Osdol, Andrew D., M.D, Borgert, Andrew J., Ph.D, Kallies, Kara J., M.S, Froman, Joshua P., M.D, Bottner, Wayne A., M.D, Shapiro, Stephen B., M.D., F.A.C.S
Format: Article
Language:English
Subjects:
Adenocarcinoma - mortality
Adenocarcinoma - pathology
Adenocarcinoma - surgery
Aged
Blood transfusion
Blood Transfusion - statistics & numerical data
Cancer recurrence
Cancer therapies
Colorectal cancer
Colorectal Neoplasms - mortality
Colorectal Neoplasms - pathology
Colorectal Neoplasms - surgery
Colorectal surgery
Decision making
Documentation
Education
Female
Hematology
Hospitals
Humans
Laboratories
Length of Stay - statistics & numerical data
Male
Medical records
Morbidity
Mortality
Neoplasm Recurrence, Local
Neoplasm Staging
Perioperative morbidity and mortality
Retrospective Studies
Surgery
Survival
Survival analysis
Survival Rate
Treatment Outcome
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Summary:Abstract Background Perioperative blood transfusion in patients with colorectal cancer has been associated with increased cost, morbidity, mortality, and decreased survival. Five years ago, a transfusion reduction initiative (TRI) was implemented. We sought to evaluate the 5-year effectiveness and patient outcomes before and after the TRI. Methods Patients who underwent colorectal resection for adenocarcinomas before (January 2006 to October 2009) and after the TRI (November 2009 to December 2013) were reviewed. Results A total of 484 patients were included; 267 and 217 patients were in the pre- and post-TRI groups, respectively. Decreased overall transfusion rates were sustained throughout the entire post-TRI era (17% vs 28%, P = .006). Three-year colorectal cancer disease-free survival rates were similar in the pre- and post-TRI eras at 85.3% (95% confidence interval [CI]: 79.9 to 89.3) and 81.6% (95% CI: 71.9 to 88.2), respectively. Three-year disease-free survival rate was lower in those receiving BTs vs those without BTs at 78.4% (95% CI: 65.7 to 86.8) vs 85.3% (95% CI: 80.4 to 89.1), respectively. Conclusions A TRI remains a safe, effective way to reduce blood utilization in colorectal cancer surgery.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2015.06.026