Preoperative predictors of blood transfusion in colorectal cancer surgery

Kent R. Nilsson, Sean Berenholtz, Todd Dorman, Elizabeth Garrett, Pamela A Lipsett, Howard S. Kaujman, Peter J. Pronovost

Research output: Contribution to journalArticle


Transfusion is associated with multiple risks and morbidities. Little is known, however, about preoperative predictors of transfusion in gastrointestinal surgery patients. To identify factors that influence transfusion practices, we analyzed hospital discharge data from colorectal cancer surgery patients in Maryland between 1994 and 2000 (n = 14,052). The primary outcome variable was whether or not patients received a blood product ("Any Transfusion"). Characteristics independently associated with an increased risk of receiving Any Transfusion included: advanced age (>80 yr: OR 2.3; 95% CI 1.9-2.9; 70-79 yr: OR 1.6; 95% CI 1.4-2.0 vs. 12 cases/yr) were at a decreased risk (OR 0.8; 95% CI 0.6-0.99). The association between greater surgeon case volume and low transfusion rates was seen in all but the very high volume hospitals (>74 cases/yr). Blood product transfusion was associated with a 2.5-fold (95% CI 2.1-3.1) increased mortality, 3.7 day (95% CI 2.1-3.1) increase in hospital length of stay, and a $7120 (95% CI $6472-$7769) increase in total charges compared to patients that did not receive Any Transfusion. This data can be used by providers in discussions with patients regarding the risks for transfusion and in identifying patients in whom strategies to reduce transfusions should be evaluated.

Original languageEnglish (US)
Pages (from-to)753-762
Number of pages10
JournalJournal of Gastrointestinal Surgery
Issue number5
Publication statusPublished - 2002



  • Blood transfusion
  • Colorectal cancer
  • Outcomes

ASJC Scopus subject areas

  • Surgery

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