• 作者：Joaquim M. Havens ; M.D.^a ; ^b ; Woo S. Do ; M.D.^a ; ^{wdo@post.harvard.edu" class="auth_mail" title="E-mail the corresponding author} ; Haytham Kaafarani ; M.D.^c ; Tomaz Mesar ; M.D.^c ; Gally Reznor ; M.S.^b ; Zara Cooper ; M.D. ; M.Sc.^a ; ^b ; Reza Askari ; M.D.^a ; Edward Kelly ; M.D.^a ; Alexandra B. Columbus ; M.D.^a ; Jonathan D. Gates ; M.D. ; M.B.A.^a ; Adil H. Haider ; M.D. ; M.P.H.^b ; Ali Salim ; M.D.^a ; ^b
• 关键词：Emergency general surgery ; Transfusion ; Surgical outcomes
• 刊名：The American Journal of Surgery
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：211
• 期：4
• 页码：656-663.e4
• 全文大小：212 K

c_2">Methods

We queried the American College of Surgery-National Surgical Quality Improvement Program database for EGS patients (2008 to 2012) at 2 tertiary academic hospitals. Outcomes included rates of high packed red blood cell (pRBC) use (estimated blood loss:pRBC < 350:1) and high fresh frozen plasma (FFP) use (FFP:pRBC >1:1.5). Patients were then stratified by exposure to high blood product use. Stepwise logistic regression was performed.

c_3">Results

Of 992 patients, 33% underwent EGS. Estimated blood loss was similar between EGS and non-EGS (282 vs 250 cc, P = .288). EGS patients were more often exposed to high pRBC use (adjusted odds ratio [OR] = 2.01, 95% confidence interval [CI] = 1.11 to 3.66) and high-FFP use (OR = 2.75, 95% CI: = 1.10 to 6.84). High blood product use was independently associated with major nonbleeding complications (high pRBC: OR = 1.73, 95% CI = 1.04 to 2.91; high FFP: OR = 2.15, 95% CI = 1.15 to 4.02).

c_4">Conclusions

Despite similar blood loss, EGS patients received higher rates of intraoperative blood product transfusion, which was independently associated with major complication.