Risk factors for adverse events after elective colorectal surgery: beware of blood transfusions

Marco Catarci; Giacomo Ruffo; Felice Borghi; Alberto Patriti; Paolo Delrio; Marco Scatizzi; Stefano Mancini; Gianluca Garulli; Alessandro Carrara; Felice Pirozzi; Stefano Scabini; Andrea Liverani; Gianluca Baiocchi; Roberto Campagnacci; Andrea Muratore; Graziano Longo; Marco Caricato; Raffaele Macarone Palmieri; Nereo Vettoretto; Paolo Ciano; Simona Ciotti; Michele Benedetti; Marcello Ceccaroni; Elisa Bertocchi; Desiree Cianflocca; Marco Migliore; Margherita Lambertini; Ugo Pace; Maddalena Baraghini; Lorenzo Pandolfini; Riccardo Angeloni; Andrea Lucchi; Giacomo Martorelli; Vincenzo Alagna; Giuseppe Tirone; Michele Motter; Antonio Sciuto; Antonio Martino; Andrea Pierre Luzzi; Tatiana di Cesare; Sarah Molfino; Angela Maurizi; Patrizia Marsanic; Federico Tomassini; Simone Santoni; Gabriella Teresa Capolupo; Pietro Amodio; Elisa Arici; Irene Marziali; Simone Cicconi; Gianluca Guercioni; Italian ColoRectal Anastomotic Lea

doi:10.1007/s13304-020-00753-2

Risk factors for adverse events after elective colorectal surgery: beware of blood transfusions

Marco Catarci, Giacomo Ruffo, Felice Borghi, Alberto Patriti, Paolo Delrio, Marco Scatizzi, Stefano Mancini, Gianluca Garulli, Alessandro Carrara, Felice Pirozzi, Stefano Scabini, Andrea Liverani, Gianluca Baiocchi, Roberto Campagnacci, Andrea Muratore, Graziano Longo, Marco Caricato, Raffaele Macarone Palmieri, Nereo Vettoretto, Paolo CianoSimona Ciotti, Michele Benedetti, Marcello Ceccaroni, Elisa Bertocchi, Desiree Cianflocca, Marco Migliore, Margherita Lambertini, Ugo Pace, Maddalena Baraghini, Lorenzo Pandolfini, Riccardo Angeloni, Andrea Lucchi, Giacomo Martorelli, Vincenzo Alagna, Giuseppe Tirone, Michele Motter, Antonio Sciuto, Antonio Martino, Andrea Pierre Luzzi, Tatiana di Cesare, Sarah Molfino, Angela Maurizi, Patrizia Marsanic, Federico Tomassini, Simone Santoni, Gabriella Teresa Capolupo, Pietro Amodio, Elisa Arici, Irene Marziali, Simone Cicconi, Gianluca Guercioni, Italian ColoRectal Anastomotic Lea

Research output: Contribution to journal › Article › peer-review

Abstract

Purpose of the present study is to analyze risk factors for adverse events after elective colorectal resection. A wide range of adverse events after elective colorectal surgery was reported, anastomotic leakage (AL) and related morbidity and mortality being the most feared ones. Clear definition of risk factors is crucial to limit the related mortality. Prospective, 1-year multicenter enrollment of 1546 elective colorectal resections with anastomosis. Endpoints were anastomotic leakage (AL), overall morbidity, major morbidity and mortality rates (ClinicalTrials.gov; Identifier: NCT03560180). AL rate was 4.92%. Overall morbidity, major morbidity and mortality rates were 30.20%, 9.76% and 1.29%, respectively. Intra- and/or postoperative blood transfusion(s) was the only variable independently influencing all the endpoints: Odds ratios (OR) were 8.15 for AL, 19.33 for overall morbidity, 10.17 for major morbidity and 3.70 for mortality); overall morbidity rates were also independently influenced by American Society of Anesthesiologists class III vs I-II and extra- vs intra-corporeal anastomosis (OR 1.57 and 1.49, respectively); major morbidity rates were also independently influenced by female vs male gender and by the length of the procedure (OR 0.60 and 1.004, respectively); mortality rates were also independently influenced by increasing age (OR 1.16). This study clearly identifies intra- and/or postoperative blood transfusion(s) as an independent risk factor for all adverse events after elective colorectal surgery.

Original language	English
Journal	Updates in Surgery
DOIs	https://doi.org/10.1007/s13304-020-00753-2
Publication status	Published - 2020

Keywords

ONCOLOGIA
STUDIO CLINICO
RIS

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10.1007/s13304-020-00753-2

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Catarci, M., Ruffo, G., Borghi, F., Patriti, A., Delrio, P., Scatizzi, M., Mancini, S., Garulli, G., Carrara, A., Pirozzi, F., Scabini, S., Liverani, A., Baiocchi, G., Campagnacci, R., Muratore, A., Longo, G., Caricato, M., Palmieri, R. M., Vettoretto, N., ... Lea, I. C. A. (2020). Risk factors for adverse events after elective colorectal surgery: beware of blood transfusions. Updates in Surgery. https://doi.org/10.1007/s13304-020-00753-2

Catarci, M, Ruffo, G, Borghi, F, Patriti, A, Delrio, P, Scatizzi, M, Mancini, S, Garulli, G, Carrara, A, Pirozzi, F, Scabini, S, Liverani, A, Baiocchi, G, Campagnacci, R, Muratore, A, Longo, G, Caricato, M, Palmieri, RM, Vettoretto, N, Ciano, P, Ciotti, S, Benedetti, M, Ceccaroni, M, Bertocchi, E, Cianflocca, D, Migliore, M, Lambertini, M, Pace, U, Baraghini, M, Pandolfini, L, Angeloni, R, Lucchi, A, Martorelli, G, Alagna, V, Tirone, G, Motter, M, Sciuto, A, Martino, A, Luzzi, AP, di Cesare, T, Molfino, S, Maurizi, A, Marsanic, P, Tomassini, F, Santoni, S, Capolupo, GT, Amodio, P, Arici, E, Marziali, I, Cicconi, S, Guercioni, G & Lea, ICA 2020, 'Risk factors for adverse events after elective colorectal surgery: beware of blood transfusions', Updates in Surgery. https://doi.org/10.1007/s13304-020-00753-2

@article{bb062891b1a440c48c7aae1720909a62,

title = "Risk factors for adverse events after elective colorectal surgery: beware of blood transfusions",

abstract = "Purpose of the present study is to analyze risk factors for adverse events after elective colorectal resection. A wide range of adverse events after elective colorectal surgery was reported, anastomotic leakage (AL) and related morbidity and mortality being the most feared ones. Clear definition of risk factors is crucial to limit the related mortality. Prospective, 1-year multicenter enrollment of 1546 elective colorectal resections with anastomosis. Endpoints were anastomotic leakage (AL), overall morbidity, major morbidity and mortality rates (ClinicalTrials.gov; Identifier: NCT03560180). AL rate was 4.92%. Overall morbidity, major morbidity and mortality rates were 30.20%, 9.76% and 1.29%, respectively. Intra- and/or postoperative blood transfusion(s) was the only variable independently influencing all the endpoints: Odds ratios (OR) were 8.15 for AL, 19.33 for overall morbidity, 10.17 for major morbidity and 3.70 for mortality); overall morbidity rates were also independently influenced by American Society of Anesthesiologists class III vs I-II and extra- vs intra-corporeal anastomosis (OR 1.57 and 1.49, respectively); major morbidity rates were also independently influenced by female vs male gender and by the length of the procedure (OR 0.60 and 1.004, respectively); mortality rates were also independently influenced by increasing age (OR 1.16). This study clearly identifies intra- and/or postoperative blood transfusion(s) as an independent risk factor for all adverse events after elective colorectal surgery.",

keywords = "ONCOLOGIA, STUDIO CLINICO, RIS",

author = "Marco Catarci and Giacomo Ruffo and Felice Borghi and Alberto Patriti and Paolo Delrio and Marco Scatizzi and Stefano Mancini and Gianluca Garulli and Alessandro Carrara and Felice Pirozzi and Stefano Scabini and Andrea Liverani and Gianluca Baiocchi and Roberto Campagnacci and Andrea Muratore and Graziano Longo and Marco Caricato and Palmieri, {Raffaele Macarone} and Nereo Vettoretto and Paolo Ciano and Simona Ciotti and Michele Benedetti and Marcello Ceccaroni and Elisa Bertocchi and Desiree Cianflocca and Marco Migliore and Margherita Lambertini and Ugo Pace and Maddalena Baraghini and Lorenzo Pandolfini and Riccardo Angeloni and Andrea Lucchi and Giacomo Martorelli and Vincenzo Alagna and Giuseppe Tirone and Michele Motter and Antonio Sciuto and Antonio Martino and Luzzi, {Andrea Pierre} and {di Cesare}, Tatiana and Sarah Molfino and Angela Maurizi and Patrizia Marsanic and Federico Tomassini and Simone Santoni and Capolupo, {Gabriella Teresa} and Pietro Amodio and Elisa Arici and Irene Marziali and Simone Cicconi and Gianluca Guercioni and Lea, {Italian ColoRectal Anastomotic}",

year = "2020",

doi = "10.1007/s13304-020-00753-2",

language = "English",

journal = "Updates in Surgery",

issn = "2038-131X",

publisher = "Springer-Verlag Italia",

}

TY - JOUR

T1 - Risk factors for adverse events after elective colorectal surgery: beware of blood transfusions

AU - Catarci, Marco

AU - Ruffo, Giacomo

AU - Borghi, Felice

AU - Patriti, Alberto

AU - Delrio, Paolo

AU - Scatizzi, Marco

AU - Mancini, Stefano

AU - Garulli, Gianluca

AU - Carrara, Alessandro

AU - Pirozzi, Felice

AU - Scabini, Stefano

AU - Liverani, Andrea

AU - Baiocchi, Gianluca

AU - Campagnacci, Roberto

AU - Muratore, Andrea

AU - Longo, Graziano

AU - Caricato, Marco

AU - Palmieri, Raffaele Macarone

AU - Vettoretto, Nereo

AU - Ciano, Paolo

AU - Ciotti, Simona

AU - Benedetti, Michele

AU - Ceccaroni, Marcello

AU - Bertocchi, Elisa

AU - Cianflocca, Desiree

AU - Migliore, Marco

AU - Lambertini, Margherita

AU - Pace, Ugo

AU - Baraghini, Maddalena

AU - Pandolfini, Lorenzo

AU - Angeloni, Riccardo

AU - Lucchi, Andrea

AU - Martorelli, Giacomo

AU - Alagna, Vincenzo

AU - Tirone, Giuseppe

AU - Motter, Michele

AU - Sciuto, Antonio

AU - Martino, Antonio

AU - Luzzi, Andrea Pierre

AU - di Cesare, Tatiana

AU - Molfino, Sarah

AU - Maurizi, Angela

AU - Marsanic, Patrizia

AU - Tomassini, Federico

AU - Santoni, Simone

AU - Capolupo, Gabriella Teresa

AU - Amodio, Pietro

AU - Arici, Elisa

AU - Marziali, Irene

AU - Cicconi, Simone

AU - Guercioni, Gianluca

AU - Lea, Italian ColoRectal Anastomotic

PY - 2020

Y1 - 2020

N2 - Purpose of the present study is to analyze risk factors for adverse events after elective colorectal resection. A wide range of adverse events after elective colorectal surgery was reported, anastomotic leakage (AL) and related morbidity and mortality being the most feared ones. Clear definition of risk factors is crucial to limit the related mortality. Prospective, 1-year multicenter enrollment of 1546 elective colorectal resections with anastomosis. Endpoints were anastomotic leakage (AL), overall morbidity, major morbidity and mortality rates (ClinicalTrials.gov; Identifier: NCT03560180). AL rate was 4.92%. Overall morbidity, major morbidity and mortality rates were 30.20%, 9.76% and 1.29%, respectively. Intra- and/or postoperative blood transfusion(s) was the only variable independently influencing all the endpoints: Odds ratios (OR) were 8.15 for AL, 19.33 for overall morbidity, 10.17 for major morbidity and 3.70 for mortality); overall morbidity rates were also independently influenced by American Society of Anesthesiologists class III vs I-II and extra- vs intra-corporeal anastomosis (OR 1.57 and 1.49, respectively); major morbidity rates were also independently influenced by female vs male gender and by the length of the procedure (OR 0.60 and 1.004, respectively); mortality rates were also independently influenced by increasing age (OR 1.16). This study clearly identifies intra- and/or postoperative blood transfusion(s) as an independent risk factor for all adverse events after elective colorectal surgery.

AB - Purpose of the present study is to analyze risk factors for adverse events after elective colorectal resection. A wide range of adverse events after elective colorectal surgery was reported, anastomotic leakage (AL) and related morbidity and mortality being the most feared ones. Clear definition of risk factors is crucial to limit the related mortality. Prospective, 1-year multicenter enrollment of 1546 elective colorectal resections with anastomosis. Endpoints were anastomotic leakage (AL), overall morbidity, major morbidity and mortality rates (ClinicalTrials.gov; Identifier: NCT03560180). AL rate was 4.92%. Overall morbidity, major morbidity and mortality rates were 30.20%, 9.76% and 1.29%, respectively. Intra- and/or postoperative blood transfusion(s) was the only variable independently influencing all the endpoints: Odds ratios (OR) were 8.15 for AL, 19.33 for overall morbidity, 10.17 for major morbidity and 3.70 for mortality); overall morbidity rates were also independently influenced by American Society of Anesthesiologists class III vs I-II and extra- vs intra-corporeal anastomosis (OR 1.57 and 1.49, respectively); major morbidity rates were also independently influenced by female vs male gender and by the length of the procedure (OR 0.60 and 1.004, respectively); mortality rates were also independently influenced by increasing age (OR 1.16). This study clearly identifies intra- and/or postoperative blood transfusion(s) as an independent risk factor for all adverse events after elective colorectal surgery.

KW - ONCOLOGIA

KW - STUDIO CLINICO

KW - RIS

U2 - 10.1007/s13304-020-00753-2

DO - 10.1007/s13304-020-00753-2

M3 - Article

JO - Updates in Surgery

JF - Updates in Surgery

SN - 2038-131X

ER -

Risk factors for adverse events after elective colorectal surgery: beware of blood transfusions

Abstract

Keywords

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