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Home > Vascular Annual Meeting^® > PP42. Blood Transfusion Is Associated with Increased...

PP42. Blood Transfusion Is Associated with Increased Morbidity and Mortality After Lower Extremity Revascularization

Eleftherios S. Xenos1,2, Daniel Davenport1, Nick Abedi1, David J. Minion1,2, Ehab Sorial1, Shane O'Keeffe1, Eric D. Endean1,2
1University of Kentucky Medical Center, Lexington, KY; 2VA Medical Center, Lexington, KY

OBJECTIVES: In adult ICU, trauma, and surgical patients, blood transfusion is associated with increased morbidity and mortality as well as increased risk of venous /arterial thrombotic events and mortality in hospitalized cancer patients . We analyzed data from the NSQIP database to examine the effect of intraoperative blood transfusion in patients undergoing lower extremity revascularization( LER).

METHODS: We queried the ACS NSQIP database from 2005 to 2007. CPT codes were used to identify LER procedures which were grouped into thromboendarterectomy (TEA), bypass with vein (BV) or prosthetic graft (BP). Multivariable analysis adjusted transfusion impact for clinical risk factors , procedure group and complexity.

RESULTS: Our query resulted in 8,799 patients, 66.8±12.0 years of age, of whom 5569 (63.3%) were male. 12% underwent TEA, 42% underwent BP and 46% underwent BV. Composite mortality was 2.9%, morbidity 25.5%. Transfusion rates varied across procedure group from 14.5% in TEA patients, 20.1% in BV patients, to 27.1% in BP patients. Intraoperative transfusion was associated with increased morbidity and mortality; after adjustment for clinical risk factors, procedure type and complexity, transfusion remained significantly predictive of poorer outcomes:
Table: 30-day outcomes for lower extremity revascularization; patients transfused intraoperatively versus not. Unadjusted rates and odds ratios adjusted for all significant ACS NSQIP clinical risk factors, procedure group and complexity.

CONCLUSIONS: Intraoperative transfusion was associated with increased morbidity and mortality and remained significantly predictive of septic, wound and pulmonary comlications after adjustment for clinical risk factors, procedure type and complexity. Graft failure rates in BP and BV patients were significantly higher in the transfused group. Prospective studies focusing on the impact of blood transfusion on lower extremity revascularization outcomes are warranted.

AUTHOR DISCLOSURES: E.S. Xenos, None; D. Davenport, None; N. Abedi, None; D.J. Minion, Gore; E. Sorial, None; S. O'Keeffe, None; E.D. Endean, None.

Table 1.