Copyright
©The Author(s) 2025.
World J Gastrointest Surg. Jul 27, 2025; 17(7): 105860
Published online Jul 27, 2025. doi: 10.4240/wjgs.v17.i7.105860
Published online Jul 27, 2025. doi: 10.4240/wjgs.v17.i7.105860
Table 1 Comparison of hospital outcomes between patients with and without transfusion, n (%)
Transfusion | Non-transfusion | P value | |
AKI | 12 (8.3) | 22 (2.7) | 0.001 |
MINS | 8 (5.5) | 10 (1.2) | 0.001 |
Respiratory complications | 23 (15.9) | 62 (7.5) | 0.001 |
Table 2 Multivariate logistic regression model for acute kidney injury, myocardial injury and respiratory complications
Risk factor | OR (95%CI) | P value | aOR (95%CI) | P value |
AKI | ||||
Blood transfusion (%) | 3.277 (1.584-6.779) | 0.001 | 2.975 (1.416-6.252) | 0.004 |
Age, year | 1.110 (1.055-1.168) | < 0.0005 | 1.101 (1.045-1.159) | < 0.0005 |
Preoperative albumin (g/dL) | 0.924 (0.847-1.008) | 0.075 | Reference | 0.514 |
MINS | ||||
Blood transfusion (%) | 4.742 (1.839-12.226) | 0.001 | 5.109 (1.943-13.438) | 0.001 |
Age, year | 1.086 (1.013-1.164) | 0.020 | Reference | 0.063 |
Heart disease (%) | 3.059 (1.069-8.750) | 0.037 | Reference | 0.075 |
Site of procedure (%) | 0.041 | 0.026 | ||
Stomach | Reference | Reference | ||
Colon | 2.912 (1.096-7.738) | 0.032 | 3.437 (1.270-9.301) | 0.015 |
Rectum | 0.466 (0.057-3.812) | 0.476 | 0.625 (0.075-5.211) | 0.664 |
ASA score (%) | Reference | 0.076 | Reference | 0.096 |
Respiratory complications | ||||
Blood transfusion (%) | 2.311 (1.380-3.869) | 0.001 | 2.221 (1.225-4.025) | 0.009 |
Age, year | 1.039 (1.002-1.077) | 0.040 | 1.033 (0.996-1.072) | 0.081 |
Preoperative hematocrit level (%) | 0.037 | 0.265 | ||
> 30.0% | - | Reference | ||
27.0%-30.0% | 0.952 (0.399-2.273) | 0.912 | 0.623 (0.251-1.594) | 0.331 |
24.0%-26.9% | 2.965 (1.415-6.216) | 0.004 | 1.815 (0.799-4.122) | 0.154 |
15.0%-23.9% | 1.252 (0.284-5.512) | 0.766 | 0.729 (0.155-3.430) | 0.689 |
Table 3 Effect of intraoperative blood transfusion on postoperative complications
Incidence (%) | aOR (95%CI) | P value | c-index | H-L statistic | |
AKI | 8.3 | 2.975 (1.416-6.252) | 0.004 | 0.711 | 5.360 |
MINS | 5.5 | 5.109 (1.943-13.438) | 0.001 | 0.757 | 2.829 |
Respiratory | 15.9 | 2.221 (1.225-4.025) | 0.009 | 0.972 | 6.189 |
Table 4 Baseline characteristics of blood transfusion and non-transfusion patients, n (%)
Characteristics | Transfusion (n = 145) | Non-transfusion (n = 822) | P value |
Age, year | 72 (68, 78) | 71 (68, 76) | 0.175 |
Males | 101 (69.7) | 595 (72.4) | 0.500 |
Blood loss (mL/kg) | 6.91 ± 6.40 | 3.26 ± 3.01 | < 0.0005 |
Weight (kg) | 61.75 ± 11.11 | 63.32 ± 10.13 | 0.089 |
Preoperative albumin (g/dL) | 36.27 ± 3.42 | 38.22 ± 4.03 | < 0.0005 |
Duration of surgery > 300 minutes | 59 (40.7) | 171 (20.8) | < 0.0005 |
Heart disease | 18 (12.4) | 93 (11.3) | 0.702 |
Hypertension | 66 (45.5) | 353 (43.1) | 0.583 |
Stroke | 17 (11.7) | 65 (7.9) | 0.128 |
Pulmonary disease | 6 (4.1) | 60 (7.3) | 0.164 |
Obesity | 21 (14.5) | 113 (13.7) | 0.813 |
Cancer stage | 0.016 | ||
I | 14 (9.6) | 170 (20.7) | |
II | 48 (33.1) | 233 (28.3) | |
III | 72 (49.7) | 350 (42.6) | |
IV | 11 (7.6) | 69 (8.4) | |
Preoperative hematocrit level | < 0.0005 | ||
> 30.0% | 70 (48.3) | 752 (91.5) | |
27.0%-30.0% | 34 (23.4) | 43 (5.2) | |
24.0%-26.9% | 26 (17.9) | 22 (2.7) | |
15.0%-23.9% | 15 (10.3) | 5 (0.6) | |
ASA score | 0.325 | ||
2 | 32 (22.1) | 155 (18.9) | |
3 | 107 (73.8) | 646 (78.6) | |
4 | 6 (4.1) | 21 (2.6) | |
Site of procedure | 0.001 | ||
Stomach | 436 (53.0) | 99 (68.3) | |
Colon | 235 (28.6) | 34 (23.4) | |
Rectum | 151 (18.4) | 12 (8.3) |
Table 5 Risk factors for intraoperative blood transfusion
Risk factor | aOR (95%CI) | P value |
Duration of surgery > 300 minutes (%) | 2.738 (1.641-4.568) | < 0.0005 |
Blood loss (mL/kg) | 1.230 (1.161-1.303) | < 0.0005 |
Preoperative hematocrit level (%) | < 0.0005 | |
> 30.0% | Reference | |
27.0%-30.0% | 12.040 (6.540-22.166) | < 0.0005 |
24.0%-26.9% | 16.408 (8.115-33.177) | < 0.0005 |
15.0%-23.9% | 36.584 (11.003-121.638) | < 0.0005 |
- Citation: Guo MM, Ji CY, Gu RR, Nan K, Miao CH, Wu QC. Risk factors and outcomes of intraoperative blood transfusion in elderly patients undergoing gastrointestinal cancer surgery. World J Gastrointest Surg 2025; 17(7): 105860
- URL: https://www.wjgnet.com/1948-9366/full/v17/i7/105860.htm
- DOI: https://dx.doi.org/10.4240/wjgs.v17.i7.105860