Faculty Collaboration Database

Blood transfusions increase the risk of venous thromboembolism following ventral hernia repair. Hernia 2019 Dec;23(6):1149-1154

Date

03/30/2019

Pubmed ID

30923979

DOI

10.1007/s10029-019-01920-0

Scopus ID

2-s2.0-85064051833 (requires institutional sign-in at Scopus site)   15 Citations

Abstract

BACKGROUND: Blood transfusions can affect the clotting cascade, leading to a hypercoagulable state. The association of a venous thromboembolic (VTE) event and perioperative blood transfusion has been identified previously in surgical patients, but not after ventral hernia repair (VHR). The aim of this study was to evaluate the risk of VTE in VHR patients who receive a perioperative blood transfusion.

METHODS: The American College of Surgeons National Surgery Quality Improvement Program was queried for open (n = 34,687) and laparoscopic (n = 11,544) VHRs that occurred from 2013 to 2015. Regression analyses were used to determine factors predictive of VTE within 30-day post-operatively, the impact of bleeding requiring blood transfusion, and the influence of surgical approach on VTE.

RESULTS: Post-operative VTE occurred in 246 (0.5%) VHR patients. Among those patients, 53.0% occurred after discharge. Increased age, operative time, and comorbidities increased the risk of VTE (p < 0.05). Controlling for surgical approach, perioperative blood transfusion increased the risk of VTE 10.2-fold (p < 0.0001) in open and 12.2-fold in laparoscopic VHR (p < 0.0001).

CONCLUSION: Perioperative blood transfusions are associated with an increased rate of VTE following VHR, more than 50% of which occur after discharge. This study highlights the importance of identifying quality initiatives for at risk patients, including adequate VTE screening and potential prophylaxis for those who receive perioperative blood transfusions.

Author List

Helm JH, Helm MC, Kindel TL, Gould JC, Higgins RM

Authors

Jon Gould MD Chief, Professor in the Surgery department at Medical College of Wisconsin
Rana Higgins MD Associate Professor in the Surgery department at Medical College of Wisconsin
Tammy Lyn Kindel MD, PhD Associate Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Blood Transfusion
Female
Hernia, Ventral
Herniorrhaphy
Humans
Laparoscopy
Male
Middle Aged
Perioperative Period
Risk Factors
Thrombophilia
Venous Thromboembolism