{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T23:17:13Z","timestamp":1785107833930,"version":"3.55.0"},"reference-count":28,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T00:00:00Z","timestamp":1652054400000},"content-version":"unspecified","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,4,8]]},"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Optimum transfusion trigger for adults undergoing cancer surgery is uncertain. Published guidelines recommend restrictive transfusion strategies in hospitalised adults. We aimed to measure the red cell transfusion rate and haemoglobin trigger in patients undergoing cancer surgery and how closely practice reflected published guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Single tertiary centre.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Adult patients undergoing surgery for upper gastrointestinal or liver malignancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>Postguideline change (2015\u20132017) versus preguideline change (2011\u20132012).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Primary: transfusion rate, secondary: transfusion trigger. Multivariable logistic regression was used to assess factors and adjust for confounders affecting our outcome measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>1578 surgical records were identified for 1520 patients. 946\/1530 (62%) patients had preoperative anaemia. The transfusion rate decreased from 23% in 2011\u20132012 to 14% in 2015\u20132017. This change remained significant after adjusting for other variables associated with transfusion rates. Mean pretransfusion haemoglobin in those who were transfused was 78\u00b113 g\/L in 2011\u20132012 and 80\u00b115 g\/L in 2015\u20132017. This change in haemoglobin transfusion triggers was not significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Transfusion rate has decreased over the study period in patients undergoing surgery for malignancy and is consistent with a restrictive transfusion strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-054193","type":"journal-article","created":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T06:46:17Z","timestamp":1652769977000},"page":"e054193","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Changes in perioperative red cell transfusion practice over time in patients undergoing surgery for upper gastrointestinal and liver cancer: a retrospective cohort study at a single tertiary centre"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6930-1085","authenticated-orcid":false,"given":"Mei Yi","family":"Yee","sequence":"first","affiliation":[{"name":"Edinburgh Medical School, The University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5018-3066","authenticated-orcid":false,"given":"Ewen","family":"Harrison","sequence":"additional","affiliation":[{"name":"Clinical Surgery, University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riinu","family":"Pius","sequence":"additional","affiliation":[{"name":"Clinical Surgery, University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Gillies","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Critical Care and Pain Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,5,9]]},"reference":[{"key":"2025121510454860000_12.5.e054193.1","unstructured":"World Health Organization . Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. World health organization 2011."},{"key":"2025121510454860000_12.5.e054193.2","doi-asserted-by":"crossref","first-page":"vii167","DOI":"10.1093\/annonc\/mdq284","article-title":"Anemia in cancer","volume":"21 Suppl 7","author":"Dicato","year":"2010","journal-title":"Ann Oncol"},{"key":"2025121510454860000_12.5.e054193.3","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1634\/theoncologist.2011-S3-12","article-title":"Management of anemia in cancer patients: transfusions","volume":"16 (Suppl 3)","author":"Schrijvers","year":"2011","journal-title":"Oncologist"},{"key":"2025121510454860000_12.5.e054193.4","first-page":"370","article-title":"Pre-Operative anaemia: prevalence, consequences and approaches to management","volume":"13","author":"Mu\u00f1oz","year":"2015","journal-title":"Blood Transfus"},{"key":"2025121510454860000_12.5.e054193.5","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.718353"},{"key":"2025121510454860000_12.5.e054193.6","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9861"},{"key":"2025121510454860000_12.5.e054193.7","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.22.2481"},{"key":"2025121510454860000_12.5.e054193.8","doi-asserted-by":"publisher","DOI":"10.1158\/0008-5472.CAN-16-1536"},{"key":"2025121510454860000_12.5.e054193.9","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3182054d06"},{"key":"2025121510454860000_12.5.e054193.10","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31825b35d5"},{"key":"2025121510454860000_12.5.e054193.11","doi-asserted-by":"crossref","unstructured":"Amato A , Pescatori M , Cochrane Colorectal Cancer Group . Perioperative blood transfusions and recurrence of colorectal cancer. Cochrane Database Syst Rev 2006;2011.doi:10.1002\/14651858.CD005033.pub2","DOI":"10.1002\/14651858.CD005033.pub2"},{"key":"2025121510454860000_12.5.e054193.12","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h1354"},{"key":"2025121510454860000_12.5.e054193.13","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i1351"},{"key":"2025121510454860000_12.5.e054193.14","unstructured":"National Institute for Health and Clinical Excellence . Transfusion: NICE guideline NG24, 2015. Available: http:\/\/www.nice.org.uk\/guidance\/ng24\/evidence\/full-guidance-2177160733"},{"key":"2025121510454860000_12.5.e054193.15","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1111\/anae.13489","article-title":"AAGBI guidelines: the use of blood components and their alternatives 2016","volume":"71","author":"Klein","year":"2016","journal-title":"Anaesthesia"},{"key":"2025121510454860000_12.5.e054193.16","first-page":"CD002042","article-title":"Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion","volume":"10","author":"Carson","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121510454860000_12.5.e054193.17","doi-asserted-by":"crossref","first-page":"e543","DOI":"10.1016\/S2352-3026(15)00198-2","article-title":"Indications for red blood cell transfusion in cardiac surgery: a systematic review and meta-analysis","volume":"2","author":"Patel","year":"2015","journal-title":"Lancet Haematol"},{"key":"2025121510454860000_12.5.e054193.18","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"},{"key":"2025121510454860000_12.5.e054193.19","doi-asserted-by":"publisher","DOI":"10.1038\/kisup.2012.1"},{"key":"2025121510454860000_12.5.e054193.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.08.1038"},{"key":"2025121510454860000_12.5.e054193.21","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeu098"},{"key":"2025121510454860000_12.5.e054193.22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2011.06819.x"},{"key":"2025121510454860000_12.5.e054193.23","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s13741-018-0109-4","article-title":"What is the effect of perioperative intravenous iron therapy in patients undergoing non-elective surgery? A systematic review with meta-analysis and trial sequential analysis","volume":"7","author":"Shah","year":"2018","journal-title":"Perioper Med"},{"key":"2025121510454860000_12.5.e054193.24","doi-asserted-by":"crossref","first-page":"2627","DOI":"10.1111\/trf.13735","article-title":"Red blood cell transfusion: 2016 clinical practice guidelines from AABB","volume":"56","author":"Tobian","year":"2016","journal-title":"Transfusion"},{"key":"2025121510454860000_12.5.e054193.25","unstructured":"Norfolk D . JPAC-Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee 7.1. 1.2. Red cell transfusion in surgery. In: Handbook of transfusion medicine. 5th Edition. London: United Kingdom Blood Services, 2014."},{"key":"2025121510454860000_12.5.e054193.26","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1097\/ALN.0000000000001162","article-title":"Restrictive versus liberal transfusion strategy in the perioperative and acute care settings: a context-specific systematic review and meta-analysis of randomized controlled trials","volume":"125","author":"Hovaguimian","year":"2016","journal-title":"Anesthesiology"},{"key":"2025121510454860000_12.5.e054193.27","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h5639"},{"key":"2025121510454860000_12.5.e054193.28","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aet068"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2021-054193","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T18:45:56Z","timestamp":1765824356000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2021-054193"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5]]},"references-count":28,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,5,9]]},"published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1136\/bmjopen-2021-054193"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2021-054193","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5]]}}}