Risk factors of a high demand for perioperative blood transfusion in patients with esophageal and cardiac cancer / 中国基层医药

ABSTRACT

Objective:To analyze the risk factors of a high demand for perioperative blood transfusion in patients with esophageal and cardiac cancer and to accumulate more evidence-based medicine findings for timely and effective clinical intervention to reduce the volume of blood transfused.Methods:The clinical data of 154 patients with esophageal and cardiac cancer who received treatment from January 2012 to October 2018 in Yuncheng Central Hospital were retrospectively analyzed. Among them, 100 patients who received < 5 U blood transfusion were included in the control group, and 54 patients who received ≥ 5 U blood transfusion were included in the observation group. The causes of a high demand for blood transfusion, the possible influential factors, and their effects on related clinical indicators post-surgery were analyzed.Results:The proportion of patients with underlying diseases, the proportion of patients with anemia pre-surgery, and the amount of blood loss in the observation group were 85.19% (46/54), 48.15% (26/54) and (1 127.92 ± 350.70) mL respectively, which were significantly higher than those in the control group [37.00% (37/100), 21.00% (21/100) and (296.47 ± 98.31) mL, χ2 = 6.17, 7.40, t = 7.54, P < 0.01, P = 0.03, P < 0.01]. The incidence of postoperative complications in the observation group was significantly higher than that in the control group [62.96% (34/54) vs. 33.00% (33/100), χ2 = 9.16, P = 0.00]. There were no significant differences in hospital and intensive care unit lengths of stay between the two groups (both P > 0.05). Platelet count after blood transfusion in the observation group was (190.47 ± 73.48) × 10 12/L, which was significantly higher than (159.00 ± 65.17) × 10 12/L in the control group and (234.31 ± 92.07) × 10 12/L before blood transfusion in the observation group ( t = 4.26, 5.33, both P < 0.01). There were no significant differences in prothrombin time and activated partial thromboplastin time between the two groups (both P > 0.05). In the observation group, the international normalized ratio after blood transfusion was significantly higher than that before blood transfusion [(1.06 ± 0.15) vs. (0.94 ± 0.12), t = 2.78, P = 0.03]. In the observation group, serum K + level after blood transfusion was significantly lower than that before blood transfusion [(3.97 ± 0.42) mmol/L vs. (4.21 ± 0.37) mmol/L, t = 4.01, P < 0.01]. There was no significant difference in serum Ca 2+ level after blood transfusion between the two groups ( P > 0.05). Conclusion:Underlying diseases and anemia are the risk factors for a high demand for blood transfusion in patients with esophageal and cardiac cancer. A high demand for blood transfusion is mainly caused by postoperative bleeding. At the same time, blood transfusion can also increase the risks for abnormal coagulation function, abnormal serum ion levels, and complications post-surgery.