Distinct risk factors for early and late blood transfusion following pancreaticoduodenectomy

The International Study Group of Pancreatic Surgery (ISGPS) has defined two periods of postpancreatectomy hemorrhage, early (24 h). A previously published Blood Usage Risk Score (BURS) aimed to predict early and late blood transfusion. The primary aim of this study was to define risk factors for ear...

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Bibliographic Details
Published in:Hepatobiliary & pancreatic diseases international 2018-08, Vol.17 (4), p.349-357
Main Authors: Bansal, Sukhchain S., Hodson, James, Khalil, Khalid, Dasari, Bobby, Marudanayagam, Ravi, Sutcliffe, Robert P., Isaac, John, Roberts, Keith J.
Format: Article
Language:English
Subjects:
Aged
Blood Loss, Surgical - prevention & control
Blood Transfusion
Decision Support Techniques
Female
Humans
Male
Middle Aged
Pancreatic cancer
Pancreaticoduodenectomy
Pancreaticoduodenectomy - adverse effects
Postoperative Hemorrhage - etiology
Postoperative Hemorrhage - therapy
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
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Summary:The International Study Group of Pancreatic Surgery (ISGPS) has defined two periods of postpancreatectomy hemorrhage, early (24 h). A previously published Blood Usage Risk Score (BURS) aimed to predict early and late blood transfusion. The primary aim of this study was to define risk factors for early and late blood transfusion after pancreaticoduodenectomy. Secondary aims were to assess the predictive accuracy of the BURS. In this retrospective observational study, multivariable analyses were used to identify independent risk factors for both early and late blood transfusion. The predictive ability of the BURS was then assessed using a receiver operating characteristic (ROC) curve analysis. Among 628 patients, 99 (15.8%) and 144 (22.9%) received early and late blood transfusion, respectively. Risk factors for blood transfusion differed between early and late periods. Preoperative anemia and venous resection were associated with early blood transfusion whilst Whipple's resection (as opposed to pylorus preserving pancreaticoduodenectomy), lack of biliary stent and a narrow pancreatic duct were predictors of late blood transfusion. The BURS was significantly predictive of early blood transfusion, albeit with a modest degree of accuracy (AUROC: 0.700, P 
ISSN:1499-3872
DOI:10.1016/j.hbpd.2018.07.001