Impact of Peri-Operative Blood Transfusion on Post-Operative Complications in Colorectal Surgery

Abstract

Aim: Colorectal cancer (CRC) is commonly associated with anaemia often requiring perioperative blood transfusions (BT). There is significant evidence to show poor long term outcomes following BT in CRC surgery due to the immunomodulatory effects of BT. This study aims to analyse the impact of BT on post-operative surgical complications in CRC surgery. Method: Data were collected retrospectively for patients undergoing emergency and elective colorectal cancer related surgery between January 2019 and December 2020 at Blacktown Hospital, Sydney. Data relating to transfusion and post-operative complications were collected through electronic medical records. R statistical software was utilised to calculate hazard ratio of common surgical complications in the blood transfusion group compared to the non-blood transfusion group. Results: There were a total of 130 patients with 26 patients (20%) receiving BT. This study shows that BT is associated with an increased risk of post-operative complication in CRC surgeries [HR 3.74 (95% CI: 1.31-10.68; P=0.0073)], after adjusting for preoperative haemoglobin. In particular, this study shows a statistically significant higher rates of intra-abdominal collection [HR 12.98 (95% CI: 1.52-111.15; P=0.0114)]. and pneumonia [HR 21.65 (95% CI: 1.77-265.01; P=0.007994)] associated with blood transfusion. Conclusion: This study shows that BT is associated with an increased risk of post-operative complication particularly intra-abdominal collection and pneumonia. However, a prospective randomised control trial is required to confirm these results.