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 journalArticlepeer-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 languageEnglish
JournalUpdates in Surgery
DOIs
Publication statusPublished - 2020

Keywords

  • ONCOLOGIA
  • STUDIO CLINICO
  • RIS

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