Incidence and risk factors associated of blood transfusion after colorectal cancer surgery：A retrospective nationwide inpatient sample database study

AIMS. This research aimed to determine the prevalence of blood transfusions and to identify preoperative variables associated with the need for blood transfusion after colorectal cancer surgery. METHODS. We analyzed 163,881 patients who had colorectal cancer surgery between 2010 and 2019 using the Nationwide Inpatient Sample. We also explored the relationship between blood transfusions and specific factors including length of stay (LOS), overall charges, and payer status. RESULTS During the study period, there was no significant change in the transfusion rate. Logistic regression analysis showed significant associations with chronic blood loss anemia, thrombocytopenia, deep vein thrombosis, peptic ulcer disease excluding bleeding, deficiency anemia, rheumatoid arthritis/collagen vascular diseases, chronic pulmonary disease, congestive heart failure, coagulopathy, depression, renal failure, diabetes, uncomplicated, hypertension, peripheral vascular disorders, liver disease, fluid and electrolyte disorders, other neurological disorders, paralysis, metastatic cancer, psychoses, pulmonary circulation disorders, valvular disease, weight loss and acquired immune deficiency syndrome. Patients who received blood transfusions had higher overall costs, longer hospital stays, and a greater likelihood of Medicare coverage compared to those who did not receive transfusions. CONCLUSIONS. Our study identified seven key risk factors for blood transfusions during colorectal cancer surgery: fluid and electrolyte disorders, paralysis, chronic blood loss anemia, peptic ulcer disease excluding bleeding, coagulopathy, deep vein thrombosis as well as thrombocytopenia. Patients with these risk factors are at increased risk of needing a blood transfusion after surgery and should receive appropriate health guidance. IMPACT. The main contribution of this study is to highlight the many risk factors present in patients undergoing surgical transfusion for colorectal cancer. This study recommends that clinical priority should be given to improving blood transfusion techniques, as well as fostering patients' awareness of disease risk factors and effective preventive.