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Area of Science:

  • Anesthesiology
  • Surgical Outcomes
  • Health Services Research

Background:

  • Perioperative transfusions are linked to adverse clinical outcomes in civilian literature.
  • Patient blood management programs (PBMPs), hemostatic agents, and surgeon training may reduce perioperative bleeding.
  • Identifying preoperative risk factors for transfusion in Veterans is crucial for targeted interventions.

Purpose of the Study:

  • To identify preoperative risk factors associated with perioperative transfusions in the Veteran population undergoing noncardiac surgery.
  • To characterize predictors of perioperative transfusion and its association with postoperative outcomes.

Main Methods:

  • Retrospective review of the Veterans Affairs Surgical Quality Improvement Project database (April 2016 - March 2021).
  • Inclusion of patients >18 years undergoing noncardiac surgery.
  • Univariate and multivariate analyses to identify predictors of perioperative transfusion.

Main Results:

  • 153 of 6108 patients received perioperative transfusions.
  • Transfusion risk factors included older age, male sex, Black race, smoking, and low body mass index (BMI).
  • Vascular, orthopedic, and general surgeries had the highest transfusion rates. Transfusion increased risk for stroke and 30-day mortality.

Conclusions:

  • Perioperative transfusions are associated with increased morbidity and mortality in Veterans after noncardiac surgery.
  • Predictive models and PBMPs are needed to decrease transfusion rates and complications in this population.
  • Understanding preoperative risk factors is foundational for developing targeted interventions.