Be Aware of Blood Transfusion in Colectomy for Diverticular Disease

Tam FS, Klein JM, Chung JP, Lee R, Duncan A, Alfonso EA and Sugiyama G

Department of Surgery, SUNY Downstate College of Medicine, USA
Department of Surgery, SUNY Downstate Medical Center, USA

^*Correspondance to: Sophia Tam 

 PDF  Full Text DOI: 10.25107/2474-1647.1027

Abstract

Introduction: Diverticular disease is one of the most frequent causes of severe lower gastrointestinal bleeding and about 15% of patients admitted for acute diverticulitis will require emergent surgical treatment. Previously, studies have focused on effects of blood transfusion in colorectal cancer resection but there is a lack of data concerning transfusion in benign colon surgery. Our objective was to analyze the effect of blood transfusion on the outcomes of emergent colectomy for diverticular disease.Methods: Patients with diverticulosis or diverticulitis of the colon who underwent emergent colectomy from 2005-2010 were selected from the ACS NSQIP and separated based on blood transfusion status. Patients with a preoperative hematocrit less than 30% were identified. Multivariate logistic and linear regression was performed to determine the effect of blood transfusion on 30-day mortality, morbidity, and length of hospital stay.Results: A total of 3,385 patients were included and 1,285 (37.9%) patients received blood transfusions. Overall, blood transfusions were associated with increased mortality (odds ratio [OR] 2.15), morbidity (OR 1.66), infectious outcomes (OR 1.36), respiratory outcomes (OR 1.77), vascular outcomes (OR 1.53) and length of stay (mean difference 2.22 days). In patients with hematocrit <30%, blood transfusion was associated with increased mortality (OR 2.90), morbidity (OR 1.77), infectious (OR 1.53) and respiratory (OR 1.75) outcomes.Conclusion: Blood transfusion in patients with acute diverticular disease following emergent colectomy is associated with increased 30-day mortality, morbidity, and length of stay. In patients with hematocrit <30%, blood transfusion is associated with increased mortality and morbidity.

Keywords

Blood transfusion; colorectal surgery; Diverticulosis; Diverticulitis; ACS NSQIP

Cite the article

Tam FS, Klein JM, Chung JP, Lee R,Duncan A, Alfonso EA, et al. Be Aware of Blood Transfusion in Colectomy for Diverticular Disease. Clin Surg. 2016;1: 1027.