Declining Use of Red Blood Cell Transfusions for Gastrointestinal Cancer Surgery: A Population-Based Analysis
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ORIGINAL ARTICLE –
HEALTH SERVICES RESEARCH AND GLOBAL ONCOLOGY
Declining Use of Red Blood Cell Transfusions for Gastrointestinal Cancer Surgery: A Population-Based Analysis Jesse Zuckerman, MDCM1,2, Natalie Coburn, MD, MPH1,2,3,4, Jeannie Callum, MD, MSc5,6, Alyson L. Mahar, PhD7, Victoria Zuk, MSc4, Yulia Lin, MD5,6, Robin McLeod, MD8, Alexis F. Turgeon, MD, MSc9,10, Haoyu Zhao, MPH11, Emily Pearsall, MSc8, Guillaume Martel, MD, MSc12, and Julie Hallet, MD, Msc1,2,3,4 1
Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Canada; 2Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada; 3Division of General Surgery, Sunnybrook Health Sciences Centre, Toronto, Canada; 4Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada; 5 Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Canada; 6 Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada; 7Department of Community Health Sciences, Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada; 8Department of Surgery, University of Toronto, Toronto, Canada; 9CHU de Que´bec – Universite´ Laval Research Centre, Population Health and Optimal Health Practices Research Unit (Trauma - Emergency - Critical Care Medicine), Universite´ Laval, Que´bec City, Canada; 10Division of Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Universite´ Laval, Que´bec City, Canada; 11ICES, Toronto, Canada; 12Department of Surgery, University of Ottawa, Ottawa, Canada
ABSTRACT Background. Gastrointestinal cancer surgery patients often develop perioperative anemia commonly treated with red blood cell (RBC) transfusions. Given the potential associated risks, evidence published over the past 10 years supports restrictive transfusion practices and blood conservation programs. Whether transfusion practices have changed remains unclear. We describe temporal RBC transfusion trends in a large North American population who underwent gastrointestinal cancer surgery. Methods. We conducted a population-based retrospective cohort study of patients who underwent gastrointestinal cancer resection between 2007 and 2018 using health
Electronic supplementary material The online version of this article (https://doi.org/10.1245/s10434-020-09291-y) contains supplementary material, which is available to authorized users. Ó Society of Surgical Oncology 2020 First Received: 4 June 2020 Accepted: 30 August 2020 J. Hallet, MD, Msc e-mail: [email protected]
administrative datasets. The outcome was RBC transfusion during hospitalization. Temporal transfusion trends were analyzed with Cochran-Armitage tests. Multivariable regression assessed the association between year of diagnosis and likelihood of RBC transfusion while controlling for confounding. Results. Of 79,764 patients undergoing gastrointestinal cancer resection, the median age was 69 years old (inte
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