Risk Factors for Blood Transfusion with Neck Dissection

Area of Science:

• Otolaryngology
• Surgical Oncology
• Transfusion Medicine

Background:

• Perioperative blood transfusions (PBTs) are common in neck dissection procedures.
• Identifying predictors of PBTs and their impact on outcomes is crucial for patient management.

Purpose of the Study:

• To identify risk factors associated with PBTs in patients undergoing neck dissection.
• To determine the association of PBTs with postoperative outcomes such as mortality, reoperation, and readmission.

Main Methods:

• Retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database (2006-2014).
• Inclusion of neck dissection procedures performed by otolaryngologists.
• Multivariable logistic regression to assess associations between patient factors and PBTs, and PBTs with outcomes.

Main Results:

• 11.2% of 3090 patients received PBTs.
• Independent risk factors for PBTs included American Society of Anesthesiologists (ASA) class ≥3, preoperative weight loss, and anemia.
• PBTs were significantly associated with unplanned return to the operating room within 30 days (OR, 4.31; 95% CI, 3.01-6.18).

Conclusions:

• Preoperative risk factors such as anemia, weight loss, and high ASA class are associated with PBTs in neck dissections.
• PBTs are linked to an increased risk of unplanned 30-day reoperation.
• Awareness of these risk factors can guide surgical decision-making and patient management to potentially reduce transfusion rates and complications.