Perioperative blood product administration and thromboembolic events in patients with treated polycythemia vera: A case-control study

Toby N. Weingarten, Ryan E. Hofer, Barrett J. Ahle, Keri M. Kemp, Jacinta A. Nkwonta, Bradly J. Narr, Animesh D Pardanani, Darrell R. Schroeder, Juraj Sprung

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: Patients with polycythemia vera (PV) have historically been considered to be at high risk for perioperative hemorrhagic and thromboembolic complications. However, no recent studies have compared these outcomes between treated PV patients and patients without PV undergoing similar procedures. STUDY DESIGN AND METHODS: Patients with PV who underwent surgery with anesthesia from June 1, 2006, to May 31, 2011, were randomly matched (sex, age, type of surgical procedure, surgical year) at a ratio of 1:4 with control patients without PV. Conditional logistic regression analysis adjusting for surgical duration, preoperative hemoglobin, platelet count, and cardiovascular disease was used to assess the association between PV and blood product transfusions, thromboembolism, and other major cardiovascular and pulmonary complications. RESULTS: Fifty-six PV patients who underwent 79 surgeries were matched with 312 controls. During hospitalization, 35 (44.3%) and 82 (25.9%) PV and control patients, respectively, were transfused with blood products. PV patients were at increased risk for transfusion intraoperatively (odds ratio [OR], 4.35; 95% confidence interval [CI], 1.79-10.57; p = 0.001) and during hospitalization (OR, 4.35; 95% CI, 1.84-10.31; p < 0.001). The likelihood of thromboembolic complications and/or other major complications did not differ between the two study groups (thromboembolic - OR 1.53, 95% CI 0.39-6.02, p = 0.540; other major complications - OR 2.15, 95% CI 0.93-4.96, p = 0.073). CONCLUSIONS: Medically managed PV patients had an increased likelihood of receiving blood products perioperatively. Given the low number of observed thromboembolic events, we cannot make definitive conclusions regarding the association between PV and thromboembolism.

Original languageEnglish (US)
Pages (from-to)1090-1097
Number of pages8
JournalTransfusion
Volume55
Issue number5
DOIs
StatePublished - May 1 2015

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Polycythemia Vera
Case-Control Studies
Odds Ratio
Confidence Intervals
Thromboembolism
Hospitalization
Platelet Count
Blood Transfusion
Hemoglobins
Cardiovascular Diseases
Anesthesia
Logistic Models
Regression Analysis

ASJC Scopus subject areas

  • Hematology
  • Immunology
  • Immunology and Allergy

Cite this

Weingarten, T. N., Hofer, R. E., Ahle, B. J., Kemp, K. M., Nkwonta, J. A., Narr, B. J., ... Sprung, J. (2015). Perioperative blood product administration and thromboembolic events in patients with treated polycythemia vera: A case-control study. Transfusion, 55(5), 1090-1097. https://doi.org/10.1111/trf.13006

Perioperative blood product administration and thromboembolic events in patients with treated polycythemia vera : A case-control study. / Weingarten, Toby N.; Hofer, Ryan E.; Ahle, Barrett J.; Kemp, Keri M.; Nkwonta, Jacinta A.; Narr, Bradly J.; Pardanani, Animesh D; Schroeder, Darrell R.; Sprung, Juraj.

In: Transfusion, Vol. 55, No. 5, 01.05.2015, p. 1090-1097.

Research output: Contribution to journalArticle

Weingarten, TN, Hofer, RE, Ahle, BJ, Kemp, KM, Nkwonta, JA, Narr, BJ, Pardanani, AD, Schroeder, DR & Sprung, J 2015, 'Perioperative blood product administration and thromboembolic events in patients with treated polycythemia vera: A case-control study', Transfusion, vol. 55, no. 5, pp. 1090-1097. https://doi.org/10.1111/trf.13006
Weingarten, Toby N. ; Hofer, Ryan E. ; Ahle, Barrett J. ; Kemp, Keri M. ; Nkwonta, Jacinta A. ; Narr, Bradly J. ; Pardanani, Animesh D ; Schroeder, Darrell R. ; Sprung, Juraj. / Perioperative blood product administration and thromboembolic events in patients with treated polycythemia vera : A case-control study. In: Transfusion. 2015 ; Vol. 55, No. 5. pp. 1090-1097.
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abstract = "BACKGROUND: Patients with polycythemia vera (PV) have historically been considered to be at high risk for perioperative hemorrhagic and thromboembolic complications. However, no recent studies have compared these outcomes between treated PV patients and patients without PV undergoing similar procedures. STUDY DESIGN AND METHODS: Patients with PV who underwent surgery with anesthesia from June 1, 2006, to May 31, 2011, were randomly matched (sex, age, type of surgical procedure, surgical year) at a ratio of 1:4 with control patients without PV. Conditional logistic regression analysis adjusting for surgical duration, preoperative hemoglobin, platelet count, and cardiovascular disease was used to assess the association between PV and blood product transfusions, thromboembolism, and other major cardiovascular and pulmonary complications. RESULTS: Fifty-six PV patients who underwent 79 surgeries were matched with 312 controls. During hospitalization, 35 (44.3{\%}) and 82 (25.9{\%}) PV and control patients, respectively, were transfused with blood products. PV patients were at increased risk for transfusion intraoperatively (odds ratio [OR], 4.35; 95{\%} confidence interval [CI], 1.79-10.57; p = 0.001) and during hospitalization (OR, 4.35; 95{\%} CI, 1.84-10.31; p < 0.001). The likelihood of thromboembolic complications and/or other major complications did not differ between the two study groups (thromboembolic - OR 1.53, 95{\%} CI 0.39-6.02, p = 0.540; other major complications - OR 2.15, 95{\%} CI 0.93-4.96, p = 0.073). CONCLUSIONS: Medically managed PV patients had an increased likelihood of receiving blood products perioperatively. Given the low number of observed thromboembolic events, we cannot make definitive conclusions regarding the association between PV and thromboembolism.",
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AU - Weingarten, Toby N.

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AU - Ahle, Barrett J.

AU - Kemp, Keri M.

AU - Nkwonta, Jacinta A.

AU - Narr, Bradly J.

AU - Pardanani, Animesh D

AU - Schroeder, Darrell R.

AU - Sprung, Juraj

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N2 - BACKGROUND: Patients with polycythemia vera (PV) have historically been considered to be at high risk for perioperative hemorrhagic and thromboembolic complications. However, no recent studies have compared these outcomes between treated PV patients and patients without PV undergoing similar procedures. STUDY DESIGN AND METHODS: Patients with PV who underwent surgery with anesthesia from June 1, 2006, to May 31, 2011, were randomly matched (sex, age, type of surgical procedure, surgical year) at a ratio of 1:4 with control patients without PV. Conditional logistic regression analysis adjusting for surgical duration, preoperative hemoglobin, platelet count, and cardiovascular disease was used to assess the association between PV and blood product transfusions, thromboembolism, and other major cardiovascular and pulmonary complications. RESULTS: Fifty-six PV patients who underwent 79 surgeries were matched with 312 controls. During hospitalization, 35 (44.3%) and 82 (25.9%) PV and control patients, respectively, were transfused with blood products. PV patients were at increased risk for transfusion intraoperatively (odds ratio [OR], 4.35; 95% confidence interval [CI], 1.79-10.57; p = 0.001) and during hospitalization (OR, 4.35; 95% CI, 1.84-10.31; p < 0.001). The likelihood of thromboembolic complications and/or other major complications did not differ between the two study groups (thromboembolic - OR 1.53, 95% CI 0.39-6.02, p = 0.540; other major complications - OR 2.15, 95% CI 0.93-4.96, p = 0.073). CONCLUSIONS: Medically managed PV patients had an increased likelihood of receiving blood products perioperatively. Given the low number of observed thromboembolic events, we cannot make definitive conclusions regarding the association between PV and thromboembolism.

AB - BACKGROUND: Patients with polycythemia vera (PV) have historically been considered to be at high risk for perioperative hemorrhagic and thromboembolic complications. However, no recent studies have compared these outcomes between treated PV patients and patients without PV undergoing similar procedures. STUDY DESIGN AND METHODS: Patients with PV who underwent surgery with anesthesia from June 1, 2006, to May 31, 2011, were randomly matched (sex, age, type of surgical procedure, surgical year) at a ratio of 1:4 with control patients without PV. Conditional logistic regression analysis adjusting for surgical duration, preoperative hemoglobin, platelet count, and cardiovascular disease was used to assess the association between PV and blood product transfusions, thromboembolism, and other major cardiovascular and pulmonary complications. RESULTS: Fifty-six PV patients who underwent 79 surgeries were matched with 312 controls. During hospitalization, 35 (44.3%) and 82 (25.9%) PV and control patients, respectively, were transfused with blood products. PV patients were at increased risk for transfusion intraoperatively (odds ratio [OR], 4.35; 95% confidence interval [CI], 1.79-10.57; p = 0.001) and during hospitalization (OR, 4.35; 95% CI, 1.84-10.31; p < 0.001). The likelihood of thromboembolic complications and/or other major complications did not differ between the two study groups (thromboembolic - OR 1.53, 95% CI 0.39-6.02, p = 0.540; other major complications - OR 2.15, 95% CI 0.93-4.96, p = 0.073). CONCLUSIONS: Medically managed PV patients had an increased likelihood of receiving blood products perioperatively. Given the low number of observed thromboembolic events, we cannot make definitive conclusions regarding the association between PV and thromboembolism.

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