Abstract
Background: There have been conflicting reports as to whether the blood transfusion may affect the recurrence of Crohn's disease (CD).The role of blood transfusion in the postoperative of recurrence in CD in current era of wide use of biologics remains to be defined. The aim of this study was to assess the impact of blood transfusion on postoperative outcome in CD in the biological era. Methods: Patients who underwent index ileocolonic resection and ileocolonic anastomosis for CD between 2000 and 2012 were identified. Clinical variables were collected from a prospective maintained CD database. The cumulative probability for blood transfusion for postoperative surgical recurrence was described by Kaplan-Meier curves. Independent effect of perioperative blood transfusion on postoperative recurrence was analyzed by multivariate analysis. Results: A total of 318 patients were included in the study. Fifty-two patients (16.5%) received blood transfusion perioperatively, and the remaining 266 (83.65%) did not. There was no difference between transfused and nontransfused patients in gender, age, disease duration, disease behavior, body mass index, smoking status, concomitant perianal disease, family history of CD, or postoperative medication use. On univariate analysis, patients receiving blood transfusion during perioperative period were more likely to develop surgical recurrence (P<0.001, Figure 1). On multivariable analysis, the risk factors for postoperative recurrences requiring further surgery were blood transfusion (hazard ratio [HR] 3.43, 95% confidence interval [CI] 1.92-6.13; P<0.001), family history of, extraintestinal manifestations, and intraoperative finding of abscess ( Table 1). Conclusions: In our series, perioperative blood transfusion was independently associated with surgical recurrence in Crohn's patients after first ileocolonic resection. Table 1 Multivariate analysis for postoperative surgical recurrence
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