Perioperative Red Blood Cell Transfusions Linked to Postoperative VTE

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As the number of intraoperative and/or postoperative red blood cell transfusion events increased, there was a significant dose-response effect.
As the number of intraoperative and/or postoperative red blood cell transfusion events increased, there was a significant dose-response effect.

HealthDay News — Perioperative red blood cell (RBC) transfusions are associated with the development of new or progressive postoperative venous thromboembolism (VTE), according to a study published online June 13 in JAMA Surgery.

Ruchika Goel, M.D., M.P.H., from New York Presbyterian Hospital in New York City, and colleagues used prospectively collected registry data from the American College of Surgery National Surgical Quality Improvement Program (ACS-NSQIP) database to examine the correlation between perioperative RBC transfusions and postoperative VTE within 30 days of surgery. A total of 750,937 patients in the ACS-NSQIP registry who underwent a surgical procedure were included in the analysis.

The researchers found that 6.3 percent of the patients received at least one perioperative RBC transfusion. Overall, 0.8 percent of patients had postoperative VTE. Perioperative RBC transfusion was correlated with increased odds of VTE, deep vein thrombosis, and pulmonary embolism (adjusted odds ratios, 2.1, 2.2, and 1.9, respectively), independent of various possible risk factors. As the number of intraoperative and/or postoperative RBC transfusion events increased, there was a significant dose-response effect (adjusted odds ratios, 2.1, 3.1, and 4.5 for one, two, and three or more events, respectively, versus no intraoperative or postoperative transfusions). Across all surgical subspecialties analyzed, the correlation between any perioperative RBC transfusion and postoperative VTE remained statistically significant.

"These findings, if validated, should reinforce the importance of rigorous perioperative management of blood transfusion practices," the authors write.

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