Patterns and timing of perioperative blood transfusion and association with outcomes after radical cystectomy

Diamantopoulos, Leonidas; Sekar, Rishi; Holt, Sarah K.; Khaki, Ali Raza; Miller, Natalie J.; Gadzinski, Adam J.; Nyame, Yaw A.; Vakar-López, Funda; Tretiakova, Maria; Psutka, Sarah P.; Gore, John L.; Lin, Daniel W.; Schade, George R.; Hsieh, Andrew C.; Lee, John K.; Yezefski, Todd; Schweizer, Michael T.; Cheng, Heather H.; Yu, Evan Y.; True, Lawrence D.; Montgomery, Robert B.; Grivas, Petros; Wright, Jonathan L.

doi:10.1016/j.urolonc.2021.01.009

Cited by 6 publications

(8 citation statements)

References 32 publications

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“…7 When considered in conjunction with previous observations that transfusion is associated with prolonged length of stay and an increased risk of cancer-specific mortality after RC, adopting a conservative approach toward blood transfusion for RC patients appears prudent. 11,15 The year of cystectomy was a significant risk factor for VTE in our study, with VTE found to be more frequent in more recent decades. This is consistent with previous data which demonstrated an increase in incidence of VTE after major cancer surgery around year 2000, 19 and likely represents a measurement bias due to development of more sensitive diagnostic tests and higher index of clinical suspicion over time.…”

Section: Discussionsupporting

confidence: 49%

Section: Discussionmentioning

confidence: 99%

“…To assess timing of perioperative transfusion, it was operationalized as a 3-tiered variable in accordance with prior literature: no transfusion, postoperative transfusion alone, or intraoperative with or without postoperative transfusion. 15 Transfusion with other blood products was not assessed. Indications for transfusion were not standardized and were based on discretion of the treating physicians.…”

Section: Exposure and Outcomesmentioning

confidence: 99%

See 2 more Smart Citations

Intraoperative Blood Transfusion Is Associated With Increased Risk of Venous Thromboembolism After Radical Cystectomy

et al. 2023

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Section: Discussionsupporting

confidence: 49%

Section: Discussionmentioning

confidence: 99%

Section: Exposure and Outcomesmentioning

confidence: 99%

See 1 more Smart Citation

Intraoperative Blood Transfusion Is Associated With Increased Risk of Venous Thromboembolism After Radical Cystectomy

et al. 2023

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“…It was independent of short-term postoperative morbidity and mortality and the scope of cancer 30 . Diamantopoulos et al reported in their retrospective cohort study involving 747 patients who underwent radical cystectomy that intraoperative blood transfusion was independently associated with lower overall survival and recurrence-free survival, but not with postoperative blood transfusion 31 . In our study, intraoperative blood transfusion was significantly associated with a decrease in one-year survival, especially in the early postoperative period (first 24 hours), reducing postoperative 30-day survival.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of perioperative parameters in patients undergoing radical cystectomy urinary diversion surgery for bladder cancer

Ergenoğlu

Ersoy

ARIBOGAN³

2022

Cukurova Medical Journal

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Purpose: The aim of this study was to evaluate the effect of red blood cell transfusion and/or inotropic/vasopressor agent infusion during intraoperative and postoperative first 24-hour period on 30-day and one-year survival. Materials and Methods: In the final analysis, 133 patients who underwent radical cystectomy and urinary diversion surgery between November 2011 and January 2019 were included in this study. Perioperative anesthesia management early postoperative intensive care patient follow-ups were based on. Results: A statistically significant relationship was found between intraoperative red blood cell transfusion and one-year mortality rates. A statistically significant relationship was found between red blood cell transfusion in the intensive care unit and postoperative 30-day mortality rates. The relationship between vasopressor/inotrope agent infusion in intensive care unit and postoperative 30-day mortality was statistically significant. Conclusion: In radical cystectomy and urinary diversion, intraoperative red blood cell and/or inotrope/vasopressor drug administration, and red blood cell transfusion within first 24 postoperative hours in intensive care unit are associated with lower survival rates in both early and late periods. Future studies should focus on developing and implementing different strategies for perioperative blood management and maintenance of patient hemodynamics that may affect early and late outcomes.

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“…Some institutions have incorporated a restrictive transfusion protocol into their standardized ERAS protocol, though this is not practiced universally. 10 Diamantopoulos et al 95 retrospectively found that PBT did not increase the risk for postoperative complications, but was associated with prolonged hospitalization ⩾ 10 days in the setting of RC (aOR: 2.30, 95% CI: 1.13–4.7, p = 0.022). Syan-Bhanvadia et al 96 conducted a retrospective study investigating the safety of a restrictive transfusion protocol between 173 patients who were transfused restrictively and 87 matched patients transfused liberally.…”

Section: Targeted Components Of Erasmentioning

confidence: 99%

Updates on enhanced recovery after surgery for radical cystectomy

Lee

Patel

Srivastava

et al. 2022

Therapeutic Advances in Urology

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Enhanced Recovery after Surgery (ERAS) is a multimodal pathway that provides evidence-based guidance for improving perioperative care and outcomes in patients undergoing surgery. In 2013, the ERAS society released its original guidelines for radical cystectomy (RC) for bladder cancer (BC), adopting much of its supporting data from colorectal literature. In the last decade, growing interest in ERAS has increased RC-specific ERAS research, including prospective randomized controlled trials (RCTs). Collective data suggest ERAS contributes to improved complication rates, decreased hospital length-of-stay, and/or time to bowel recovery. Various institutions have adopted modified versions of the ERAS pathway, yet there remains a lack of consensus on the efficacy of specific ERAS items and standardization of the protocol. In this review, we summarize updated evidence and practice patterns of ERAS pathways for RC since the introduction of the original 2013 guidelines. Novel target interventions, including use of immunonutrition, prehabilitation, alvimopan, and methods of local analgesia are reviewed. Finally, we discuss barriers to implementing and future steps in advancing the ERAS movement.

show abstract

Patterns and timing of perioperative blood transfusion and association with outcomes after radical cystectomy

Cited by 6 publications

References 32 publications

Intraoperative Blood Transfusion Is Associated With Increased Risk of Venous Thromboembolism After Radical Cystectomy

Intraoperative Blood Transfusion Is Associated With Increased Risk of Venous Thromboembolism After Radical Cystectomy

Evaluation of perioperative parameters in patients undergoing radical cystectomy urinary diversion surgery for bladder cancer

Updates on enhanced recovery after surgery for radical cystectomy

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