Perioperative Blood Transfusion and Postoperative Outcome in Patients with Crohn’s Disease Undergoing Primary Ileocolonic Resection in the “Biological Era”

Li, Yang; Stocchi, Luca; Rui, Yuanyi; Liu, Ganglei; Görgün, Emre; Remzi, Feza H.; Shen, Bo

doi:10.1007/s11605-015-2893-1

Cited by 17 publications

(13 citation statements)

References 72 publications

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“…It has been suggested that perioperative blood transfusion is connected with inflammatory response as well as immunosuppression, and developing postoperative morbidity may occur in patients who received blood transfusion [20]. Blood transfusion inhibits cellular immunity by decreasing cutaneous delayed-type hypersensitivity, reduction of T-cell proliferation, and inactivation of natural killer cell function, as well as driving the immune system toward a T-helper 2 response from a T-helper 1 response [21].…”

Section: Discussionmentioning

confidence: 99%

Correlations of Hemoglobin Level and Perioperative Blood Transfusion with the Prognosis of Gastric Cancer: A Retrospective Study

Zhang

Duan

et al. 2017

Med Sci Monit

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BackgroundThis study was designed to explore the correlations of hemoglobin level (Hb) and perioperative blood transfusion with the prognosis of gastric cancer (GC).Material/MethodsOur study consisted of 210 patients with GC who all received a D2 radical operation. These patients were assigned into three groups: 68 cases in group A (blood transfusion >5 U); 59 cases in group B (blood transfusion <5 U); 83 cases in group C (without blood transfusion). A 5-year follow-up was conducted to evaluate the disease-free survival of the patients. Univariate analysis was performed to reveal the relationship between the indicators and the patients with GC. Kaplan-Meier method was employed to analyze the survival rate of patients, and Cox regression analysis was applied to determine the independent prognostic factors of GC.ResultsThe univariate analysis indicated that age, perioperative blood transfusion amount, TNM staging, maximal tumor diameter, differentiation degree and invasion degree were associated with the prognosis of GC. The Kaplan-Meier curve showed that the disease-free survival rate was declined in the patients who were older, those received more amount of blood transfusion, those in advanced TNM staging, those had larger tumor diameter, and those with decreased degree of differentiation and invasion. Cox regression analysis indicated that perioperative blood transfusion, maximal tumor diameter and invasion degree were the independent factors affecting disease-free survival of the GC.ConclusionsOur study revealed that large amount of perioperative blood transfusion leads to poor prognosis of GC.

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Section: Discussionmentioning

confidence: 99%

Correlations of Hemoglobin Level and Perioperative Blood Transfusion with the Prognosis of Gastric Cancer: A Retrospective Study

Zhang

Duan

et al. 2017

Med Sci Monit

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“…Anemia is more prevalent in IBD patients due to iron deficiency, anemia of chronic disease, or vitamin B12 deficiency [19] with CD patients having higher incidence than UC patients [20]. In addition, perioperative blood transfusion has been shown to be associated with post-operative infection and worse hospital outcomes in CD [21]. Therefore, pre-operative optimization of anemia, for instance intravenous iron therapy, may improve outcomes of CD patients undergoing surgery [22].…”

Section: Discussionmentioning

confidence: 99%

Appendectomy for Appendicitis Has Worse Hospital Outcomes in Inflammatory Bowel Disease Patients

Pavurala¹,

Johnson²,

Hinton³

et al. 2018

JBM

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Background and Aims: Appendectomy is the choice of surgery for appendicitis but little is known about its outcomes in patients with Inflammatory Bowel Disease (IBD). We sought to compare hospital outcomes of appendectomy for appendicitis between patients with and without IBD. Methods: This is a cross-sectional study utilizing the Nationwide Inpatient Sample between 2009 and 2013. Patients with appendicitis undergoing appendectomy were identified using appropriate International Classification of Diseases codes. Primary outcomes of interest included length of stay (LOS), hospital costs, and post-surgical complications. Univariate and multivariate analyses were used to compare these outcomes between patients with and without IBD. Results: A total of 849,312 patients with appendicitis undergoing appendectomy were included in this study, of which 4261 patients had IBD. IBD patients had longer LOS and increased hospital costs. Crohn's disease (CD) patients were more likely to develop post-operative pulmonary embolism (adjusted odds ratio (aOR) 7.06, 95% Confidence Interval (CI) (2.19, 22.79)) and anemia (aOR 2.23, 95% CI (1.21, 4.10)), whereas ulcerative colitis patients were more likely to develop post-operative deep vein thrombosis (aOR 9.79, 95% CI (2.41, 39.75)). CD patients were more likely to have perforated appendicitis (aOR 1.37, 95% CI (1.67, 1.11)) and open appendectomy (aOR 1.56, 95% CI (1.96, 1.27)). Conclusions: Appendectomy for appendicitis in IBD patients is associated with adverse hospital outcomes. Focused attempts are needed to decrease the risk of DVT and PE in these patients. Treating patient's pre-surgical anemia and proactive venous thromboembolism prophylaxis in IBD patients How to cite this paper:

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“… 12 Perioperative blood transfusion has been shown to be associated with postoperative infection and worse hospital outcomes. 20 Therefore, preoperative optimization of anemia; for instance, intravenous iron therapy, may be an avenue to improve outcomes of CRC surgery in IBD patients. 21 …”

Section: Discussionmentioning

confidence: 99%

Inflammatory Bowel Disease Adversely Impacts Colorectal Cancer Surgery Short-term Outcomes and Health-Care Resource Utilization

Ramsey

Krishna

Stanich

et al. 2017

Clinical and Translational Gastroenterology

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Objectives:Inflammatory bowel disease (IBD) is associated with an increased risk of colorectal cancer (CRC) compared to patients without IBD. There is a lack of population-based data evaluating the in-patient surgical outcomes of CRC in IBD patients. We sought to compare the hospital outcomes of CRC surgery between patients with and without IBD.Methods:We used the National Inpatient Sample (2008–2012) and Nationwide Readmissions Database (NRD, 2013) and selected all adult patients (age ≥18 years) with ulcerative colitis (UC) or Crohn’s disease (CD) who underwent CRC surgery. Multivariate analysis for in-patient outcomes of postoperative complications, health-care resource utilization, readmission rate, and mortality were performed.Results:A total of 397,847 patients underwent CRC surgery from 2008 to 2012, of which 0.8% (3,242) had IBD. Compared to CRC in non-IBD patients, CRC in IBD patients had longer length of stay (adjusted coefficient (AC) 0.86 days, 95% confidence interval (CI): 0.42, 1.30), more likely developed postoperative complications (adjusted odds ratio (AOR) 1.26, 95% CI: 1.06, 1.50), including postoperative infection (AOR 1.69, 95% CI: 1.20, 2.38) and deep vein thrombosis (AOR 2.42, 95% CI: 1.36, 4.28), and more frequently required blood transfusion (AOR 1.59, 95% CI: 1.30, 1.94). CRC in IBD patients was more likely to be readmitted within 30 days (AOR 1.44, 95% CI: 1.01, 2.04).Conclusion:At a population level, IBD adversely impacts outcomes at the time of CRC surgery.

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Perioperative Blood Transfusion and Postoperative Outcome in Patients with Crohn’s Disease Undergoing Primary Ileocolonic Resection in the “Biological Era”

Abstract: Adverse outcomes after perioperative blood transfusion for the primary ileocolonic resection for CD resemble findings in surgery for other diseases. The presumed immunosuppressive effect of blood transfusion did not confer any protective effect on disease recurrence.

Cited by 17 publications

References 72 publications

Correlations of Hemoglobin Level and Perioperative Blood Transfusion with the Prognosis of Gastric Cancer: A Retrospective Study

Correlations of Hemoglobin Level and Perioperative Blood Transfusion with the Prognosis of Gastric Cancer: A Retrospective Study

Appendectomy for Appendicitis Has Worse Hospital Outcomes in Inflammatory Bowel Disease Patients

Inflammatory Bowel Disease Adversely Impacts Colorectal Cancer Surgery Short-term Outcomes and Health-Care Resource Utilization

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