Anaemia and transfusion in nonagenarians undergoing emergency, non‐traumatic surgery: a prospective observational study. Issue 4 (7th February 2013)

• Record Type: Journal Article
• Authors: Pelavski, A. D.; de Miguel, M.; Lacasta, A.; Rochera, M. I.; Roca, M.
• Is Part Of: Transfusion medicine. Volume 23:Issue 4(2013)
• Page Start: 238
• Page End: 244
• Publication Date: 2013-02-07
• Subjects: Blood -- Transfusion -- Periodicals; 615.39
• DOI: 10.1111/tme.12011
• Languages: English
• ISSNs: 0958-7578

Abstract

<abstract abstract-type="main"> <title>SUMMARY</title> <sec id="tme12011-sec-0001" sec-type="section"> <title>Objectives</title> <p>To characterise transfusion and determine its main predictors in nonagenarians undergoing non‐elective, non‐traumatic surgery. Simultaneously, we compared nonagenarians to a similar, but younger sample, as far as the transfusional policy is concerned.</p> </sec> <sec id="tme12011-sec-0002" sec-type="section"> <title>Background</title> <p>Perioperative anaemia and transfusion are currently topical, but little is known about them in this population.</p> </sec> <sec id="tme12011-sec-0003" sec-type="section"> <title>Methods</title> <p>In this prospective observational study, we recruited 135 patients older than 90 who underwent a non‐elective, non‐traumatic procedure, between 2006 and 2011. A descriptive statistical analysis was performed and a logistic regression model developed. As a control sample, we used a similar number of patients in their third age (between 65 and 85 years old), who underwent the same procedure, during the same period.</p> </sec> <sec id="tme12011-sec-0004" sec-type="section"> <title>Results</title> <p>Thirty‐five per cent of the nonagenarians were transfused. The main independent factors associated with transfusion were anaemia (OR 6·77, <italic>P</italic> < 0·01), a coexisting neoplasm (OR 10·99, <italic>P</italic> < 0·01) and the need for an exploratory laparotomy (OR 3·05, <italic>P</italic> = 0·01). When comparing the nonagenarians to the younger group, we found a significant difference in their basal health status and the mortality rate (<italic>P</italic> < 0·01), but the transfusion policy did not differ substantially, except for the haemoglobin threshold (<italic>P</italic> = 0·01).</p> </sec> <sec id="tme12011-sec-0005" sec-type="section"> <title>Conclusions</title> <p>The independent transfusion predictors in nonagenarians should be taken into account for cross‐matching. Transfusional policy being similar between nonagenarians and third‐aged patients; the differences in thresholds were due to the differences in the populations.</p> </sec> </abstract>