A Comprehensive Assessment of Blood Transfusions in Elective Thyroidectomy Based on 180,483 Patients

Abstract

Objectives To assess the incidence, risk factors, and complications of blood transfusions (BTs) in elective thyroidectomy patients. Methods A retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program. Adult patients who underwent elective thyroidectomy from 2005 to 2019 were divided into two cohorts based on whether they received BT or not. Multivariable binary logistic regression models were used to identify risk factors of BT and its impact on postoperative complications. Results Of 180,483 patients, 0.13% received BT. Risk factors for BT included underweight body mass index (BMI) (adjusted odds ratio [OR] 3.179, 95% confidence interval [CI] 1.444–6.996), bleeding disorders (OR 2.121, 95% CI 1.149–3.913), anemia (OR 4.730, 95% CI 3.472–6.445), preoperative transfusion (OR 7.230, 95% CI 1.454–35.946), American Society of Anesthesiology physical statuses 3–5 (OR 3.103, 95% CI 2.143–4.492), operative time >150 min (OR 4.390, 95% CI 1.996–9.654), and inpatient thyroidectomy (OR 5.791, 95% CI 3.816–8.787). In addition, transfusion was independently associated with any postoperative complication, non‐infectious, cardiac, pulmonary, renal, vascular, or infectious complications, surgical site infection, sepsis, septic shock, wound disruption, pneumonia, unplanned reoperation, prolonged length of stay, and mortality. Conclusion Recognition of risk factors of BT is imperative to identify at‐risk patients and reduce transfusions by controlling modifiable risk factors such as anemia, operative time, and BMI. In cases where transfusions are still indicated, surgeons should optimize care to prevent or adequately manage transfusion‐associated complications. Level of Evidence 3 Laryngoscope, 132:2078–2084, 2022

Noninfectious Complications of Blood Transfusion in the South of Kerman Province: A 4-Year Retrospective Study

“…The present study indicated that most complications of blood transfusion occurred in people over the age of 50, which is similar to the study by Waqar et al (24), females which is similar to studies by Gotekar and Khade (25) and Amiri et al (26), and the O blood group which is similar to study Asgharniya et al (27). In their study, Asgharnia et al (27) and Gotekar and Khade (25) reported the most complications of blood transfusion in people under 50, which is different from the present study.…”