Allogenic Blood Transfusion During Elective Open Abdominal Aortic Surgery
Condition: Blood Transfusion
Study type: Observational

Summary: 
      Open surgery on the abdominal aorta is a high risk procedure associated with an intravascular
      volume blood loss and thereby, with high requirement for blood and blood product transfusion.

      The aim of this study was to establish the rate for allogenic blood transfusion (ABT) during
      elective open abdominal aortic surgery and find parameters associated with ABT requirements.
    

Detailed description: 
      Two distinct clinical entities affect the abdominal aorta: abdominal aortic aneurysm (AAA)
      and aortoiliac occlusive disease (AIOD). These are multifactorial vascular disorders caused
      by complex genetic and environmental factors. Older patients with more comorbidity are often
      affected. Open abdominal aortic surgery is associated with high mortality rate. Even in
      specialised institutions it varies from 2 to 5%. Similar results can be compared to mortality
      for coronary artery bypass grafting. This reflects the complexity of the surgery and the
      general health of those patients. It is associated with intravascular volume blood loss and,
      thereby, with a high requirement for blood and blood products transfusion. Allogenic blood
      transfusion (ABT) has been associated with an increased risk of tumour recurrence,
      postoperative infection, acute lung injury, perioperative myocardial infarction,
      postoperative low-output cardiac failure, and increased mortality.

      In the last decades, multiple strategies have been undertaken to prevent massive
      intraoperative blood loss during elective surgery and allogenic blood transfusion
      requirement. One of the method advocates a preoperative increase in red blood cells level
      using B12, folic acid and iron supplements or with erythropoietin usage. Other methods
      involve the optimisation of surgical technique and the use of a machine for intraoperative
      blood salvage, known as "cell saver".

      The aim of this study was to establish the rate for ABT during elective open abdominal aortic
      surgery, find parameters associated with ABT requirements, and optimise the investigators
      hospital's maximum surgical blood ordering schedule (MSBOS).
    

Intervention name(s): Allogenic blood transfusion (ABT)
Intervention type(s): Other
Intervention description(s): During elective open aortic surgery, the autologous blood from ICS was processed and re-transfused in all patients. However, TR group additionally received ABT.
Observational model: Cohort
Time perspective: Retrospective
Sampling method: Probability Sample
Study population: 
        A retrospective cross-sectional study was conducted using an existing computerised medical
        records database at the Department of Anaesthesiology and Intensive Care at the Clinic for
        Cardiovascular Diseases Magdalena. This Clinic is a tertiary hospital in Croatia
        specialised in cardiac and vascular surgery. This study is a retrospective analysis of
        consecutive patients undergoing elective major vascular surgery who had been prospectively
        risk-stratified.
      
Keywords: Aorta, abdominal; Intraoperative blood salvage; Elective surgical procedures; Patient outcomes assessment