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World Journal of Urology

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01-09-2017 | Original Article

Peri-operative allogeneic blood transfusion and outcomes after radical cystectomy: a population-based study

Authors: D. Robert Siemens, Melanie T. Jaeger, Xuejiao Wei, Francisco Vera-Badillo, Christopher M. Booth

Published in: World Journal of Urology | Issue 9/2017

Abstract

Introduction

To describe factors associated with peri-operative blood transfusion (PBT) at radical cystectomy (RC) for patients with bladder cancer and evaluate its association on both early and late outcomes.

Methods

Electronic records of treatment and surgical pathology reports were linked to the population-based Ontario Cancer Registry to identify all patients who underwent RC between 2000 and 2008. Modified Poisson regression model was used to determine the factors associated with PBT. A Cox-proportional hazards regression model was used to explore the association between PBT and overall (OS) and cancer-specific (CSS) survival.

Results

Among 2593 patients identified, 62% received an allogeneic red blood cell transfusion. The frequency of PBT decreased over the study period (from 68 to 54%, p < 0.001). Factors associated with PBT included age, sex, greater co-morbidity, stage, and surgeon volume. PBT was associated with inferior outcomes, including median length of stay (11 vs. 9 days, p < 0.001), 90-day re-admission rate (38 vs. 29%, p < 0.001), and mortality (11 vs. 4%, p < 0.001). OS and CSS at 5 years were lower among patients with PBT on multivariate analysis (OS HR 1.33, 95% CI 1.20–1.48; CSS HR 1.39, 95% CI 1.23–1.56).

Conclusions

Although rates are decreasing, these data suggest a very high utilization rate of PBT at time of RC in routine clinical practice. PBT is associated with substantially worse early outcomes and long-term survival. This association persists despite adjustment for disease-, patient-, and provider-related factors, suggesting that PBT is an important indicator of surgical care of RC.

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Title: Peri-operative allogeneic blood transfusion and outcomes after radical cystectomy: a population-based study
Authors: D. Robert Siemens
Melanie T. Jaeger
Xuejiao Wei
Francisco Vera-Badillo
Christopher M. Booth
Publication date: 01-09-2017
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 9/2017
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-017-2009-5

2024 ASCO Annual Meeting

Springer Medicine

Peri-operative allogeneic blood transfusion and outcomes after radical cystectomy: a population-based study

Abstract

Introduction

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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