Preoperative risk factors predict perioperative allogenic blood transfusion in patients undergoing primary lung cancer resections – a retrospective cohort study from a high-volume thoracic surgery center

M-G Stoleriu; M Gerckens; J Zimmermann; J Schön; F Damirov; N Samm; J Kovács; E Stacher-Priehse; C Kellerer; R A Jörres; T Kauke; C Ketscher; U Grützner; R Hatz

doi:10.1055/s-0043-1771138

Zentralblatt für Chirurgie - Zeitschrift für Allgemeine, Viszeral-, Thorax- und Gefäßchirurgie, Table of Contents

Zentralbl Chir 2023; 148(S 01): S93
DOI: 10.1055/s-0043-1771138

Abstracts

Freie Themen

Preoperative risk factors predict perioperative allogenic blood transfusion in patients undergoing primary lung cancer resections – a retrospective cohort study from a high-volume thoracic surgery center

M-G Stoleriu

¹Division of Thoracic Surgery Munich, Hospital of Ludwig-Maximilians-University Munich (LMU) and Asklepios Pulmonary Hospital Munich-Gauting, Department of Thoracic Surgery, Munich-Gauting, Deutschland

²Institute for Lung Health and Immunity and Comprehensive Pneumology Center with the CPC-M bioArchive; Helmholtz Zentrum Munich; Member of the German Lung Research Center (DZL), 81377, Munich, Deutschland

,

M Gerckens

²Institute for Lung Health and Immunity and Comprehensive Pneumology Center with the CPC-M bioArchive; Helmholtz Zentrum Munich; Member of the German Lung Research Center (DZL), 81377, Munich, Deutschland

³Department of Medicine V, Hospital of Ludwig-Maximilians-University Munich (LMU), Munich, Deutschland

,

J Zimmermann

¹Division of Thoracic Surgery Munich, Hospital of Ludwig-Maximilians-University Munich (LMU) and Asklepios Pulmonary Hospital Munich-Gauting, Department of Thoracic Surgery, Munich-Gauting, Deutschland

,

J Schön

¹Division of Thoracic Surgery Munich, Hospital of Ludwig-Maximilians-University Munich (LMU) and Asklepios Pulmonary Hospital Munich-Gauting, Department of Thoracic Surgery, Munich-Gauting, Deutschland

,

F Damirov

¹Division of Thoracic Surgery Munich, Hospital of Ludwig-Maximilians-University Munich (LMU) and Asklepios Pulmonary Hospital Munich-Gauting, Department of Thoracic Surgery, Munich-Gauting, Deutschland

,

N Samm

¹Division of Thoracic Surgery Munich, Hospital of Ludwig-Maximilians-University Munich (LMU) and Asklepios Pulmonary Hospital Munich-Gauting, Department of Thoracic Surgery, Munich-Gauting, Deutschland

,

J Kovács

⁴Division of Thoracic Surgery Munich, Hospital of Ludwig-Maximilians-University Munich (LMU) and Asklepios Pulmonary Hospital Munich-Gauting, Department of Thoracic Surgery, Munich, Deutschland

,

E Stacher-Priehse

⁵Asklepios Pulmonary Hospital, Department of Pathology, Munich-Gauting, Deutschland

,

C Kellerer

⁶Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Hospital of Ludwig-Maximilians-University Munich (LMU), Munich, Deutschland

,

R A Jörres

⁶Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Hospital of Ludwig-Maximilians-University Munich (LMU), Munich, Deutschland

,

T Kauke

⁷Division of Thoracic Surgery Munich, Hospital of Ludwig-Maximilians-University Munich (LMU), Department of Thoracic Surgery, Munich, Deutschland

,

C Ketscher

¹Division of Thoracic Surgery Munich, Hospital of Ludwig-Maximilians-University Munich (LMU) and Asklepios Pulmonary Hospital Munich-Gauting, Department of Thoracic Surgery, Munich-Gauting, Deutschland

,

U Grützner

¹Division of Thoracic Surgery Munich, Hospital of Ludwig-Maximilians-University Munich (LMU) and Asklepios Pulmonary Hospital Munich-Gauting, Department of Thoracic Surgery, Munich-Gauting, Deutschland

,

R Hatz

¹Division of Thoracic Surgery Munich, Hospital of Ludwig-Maximilians-University Munich (LMU) and Asklepios Pulmonary Hospital Munich-Gauting, Department of Thoracic Surgery, Munich-Gauting, Deutschland

› Author Affiliations

Abstract

Full Text

Background Our study aimed to identify preoperative predictors for perioperative allogenic blood transfusion (ABT) in patients undergoing major lung cancer resections in order to improve the perioperative management of patients at risk for ABT.

Material and Methods Patients admitted between 2014 and 2016 in a high-volume thoracic surgery clinic were retrospectively evaluated in a cohort study based on a control group without ABT and the ABT group requiring packed red blood cell units within 15 days postoperatively until discharge. The association of ABT with clinically established parameters (sex, preoperative anemia, liver and coagulation function, blood groups, multilobar resections) was analyzed by contingency tables, receiver operating characteristics (ROC) and logistic regression analysis, taking into account potential covariates.

Results 60 out of 529 patients (11.3%) required ABT. N1 and non-T1 tumors, thoracotomy approach, multilobar resections, thoracic wall resections and Rhesus negativity were more frequent in the ABT group. In multivariable analyses, female sex, preoperative anemia, multilobar resections, as well as serum alanine-aminotransferase levels, thrombocyte counts and Rhesus negativity were identified as independent predictors of ABT, being associated with OR (95% Confidence interval, p-value) of 2.44 (1.23-4.88, p=0.0112), 18.16 (8.73-37.78, p<0.0001), 5.79 (2.50-13.38, p<0.0001), 3.98 (1.73-9.16, p=0.0012), 2.04 (1.04-4.02, p=0.0390) and 2.84 (1.23-6.59, p=0.0150), respectively.

Conclusion In patients undergoing major lung cancer resections, multiple independent risk factors for perioperative ABT apart from preoperative anemia and multilobar resections were identified. Assessment of these predictors might help to identify high risk patients preoperatively and to improve the strategies that reduce perioperative ABT.