NDLI: Predicting blood transfusion needs in colorectal surgery at a university hospital in Saudi Arabia: insights into anemia, malnutrition, and surgical factors

Content Provider	Springer Nature : BioMed Central
Author	Farsi, Sara
Abstract	Background In Saudi Arabia, nearly a quarter of a hospital’s blood supply is consumed in operating rooms. However, blood is a scarce resource, and its unavailability has led to the cancellation of many surgeries. This study aims to identify risk factors for perioperative blood transfusion in colorectal surgery, thus providing valuable insights for better blood management and transfusion planning. Methods We conducted a retrospective cohort study of patients who underwent colorectal surgery at King Abdulaziz University Hospital from 2013 to 2022. Data on patient demographics, comorbidities, surgical details, and transfusion outcomes were collected and analyzed. Statistical analyses included logistic regression to identify predictors of transfusion and over-transfusion. Results We collected data from 434 patients. Women were almost twice as likely (OR = 1.98; 95%CI = 1.35–2.90) as men to receive one or more units of RBCs. Also more likely to be transfused were patients with a higher ASA score; a lower pre-operative serum hemoglobin (Hgb) level; and malignant disease as the reason for surgery (all p < 0.001). On multivariable analysis, receiving a transfusion of packed blood cells (RBCs) was statistically linked to volume of intra-operative blood loss and Hgb level (both p < 0.001); as well as to pre-operative body mass index (BMI), with patients who were under-weight and of normal weight most at risk, and patients with a BMI between 25 and 35 less likely to be transfused. Patients whose pre-operative serum Hgb level was 12 g/dL or higher were more than twice as likely to not receive a transfusion, while those with pre-operative Hgb levels from 8.0 to 9.9 g/dL were three times more likely than not to receive blood, and those with a pre-operative Hgb under 8.0 g/dL almost five times as likely as not. Conclusions Key risk factors for perioperative blood transfusion in colorectal surgery are preoperative anemia, diabetes, low BMI, and significant blood loss. Addressing these through a multidisciplinary approach and the development of perioperative protocols may reduce transfusion needs. Future prospective studies are needed to validate these findings and refine transfusion risk assessments.
Related Links	https://perioperativemedicinejournal.biomedcentral.com/counter/pdf/10.1186/s13741-024-00449-w.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	20470525
DOI	10.1186/s13741-024-00449-w
Journal	Perioperative Medicine
Issue Number	1
Volume Number	13
Language	English
Publisher	BioMed Central
Publisher Date	2024-09-16
Access Restriction	Open
Subject Keyword	Intensive Critical Care Medicine Emergency Medicine Surgery Human Physiology Perioperative transfusion Colorectal surgery Anemia Blood management Transfusion risk factors Replacement donors Saudi Arabia
Content Type	Text
Resource Type	Article
Subject	Surgery
Journal Impact Factor	2/2023
5-Year Journal Impact Factor	2.6/2023

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