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[Perioperative transfusion in prostatic surgery]
V Pinto García1, J L Guate Ortiz, R Baldonedo Cernuda
1Servicio de Hematología, Hospital Central de Asturias, Oviedo, España.
Insights
The likelihood of perioperative transfusion in prostate surgery is influenced by factors like cancer diagnosis and radical prostatectomy. Individual risk assessment aids in planning transfusions and pretransfusion tests.
Area of Science:
- Urology
- Transfusion Medicine
Context:
- Prostate surgery carries a risk of perioperative transfusion.
- Understanding predictors of transfusion is crucial for patient management.
Purpose:
- To analyze the likelihood of perioperative transfusion in patients undergoing prostate surgery.
- Identify factors associated with increased transfusion risk.
Summary:
- A review of 204 prostate surgery patients found 14.2% required transfusion.
- Radical prostatectomy, advanced age (>75), and concurrent bladder surgery significantly increased transfusion likelihood.
- Multivariate analysis revealed adjusted odds ratios of 10.14 for radical prostatectomy, 2.67 for age >75, and 2.85 for simultaneous bladder surgery.
Impact:
- Identifies key risk factors for perioperative transfusion in prostate surgery.
- Highlights the variability in transfusion likelihood (3.5%–83.4%).
- Suggests individual risk estimation can optimize transfusion planning, pretransfusion testing, and autologous blood utilization.
Objective:
To analyze the likelihood of perioperative transfusion in prostate surgery.
Methods:
The records of patients who underwent prostate surgery at the Hospital Central de Asturias en 1996 were reviewed. The abstracted patient discharge records, encoded according to the ICD-9-CM, were analyzed for gender, age, diagnosis, surgical and non-surgical procedures, including transfusions of blood products.
Results:
29 (14.2%) of 204 operated patients required transfusion. By univariate analysis, the likelihood of requiring transfusion was significantly higher in patients with cancer (28.8%), patients undergoing radical prostatectomy (40%), and those undergoing more than one surgical procedure (21.2%). By multivariate logistic regression analysis, the surgical procedure, age and simultaneous urinary bladder surgery were related with the likelihood of requiring transfusion. The adjusted odds ratio for perioperative transfusion was 10.14 times in radical prostatectomy than in transurethral prostatectomy, 2.67 times for patients more than 75 years than in those aged less, and 2.85 times in patients undergoing simultaneous urinary bladder surgery than those who do not.
Conclusions:
Due to the wide range of variability of the adjusted likelihood for transfusion in prostate surgery (3.5% to 83.4%), estimation of the individual likelihood for transfusion could be useful for planning surgical transfusions, pretransfusion tests and autologous transfusion in these patients.