A systematic review and meta-analysis of blood transfusion rates during liver resection by country
10.4174/astr.2023.105.6.404
- Author:
Seonju KIM
1
;
Yun Kyung JUNG
;
Kyeong Geun LEE
;
Kyeong Sik KIM
;
Hanjun KIM
;
Dongho CHOI
;
Sumi LEE
;
Boyoung PARK
Author Information
1. Department of Public Health Sciences, Hanyang University College of Medicine, Seoul, Korea
- Publication Type:ORIGINAL ARTICLE
- From:Annals of Surgical Treatment and Research
2023;105(6):404-416
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:This study aimed to determine the blood transfusion rates during liver resection by country to prepare a basis for patient blood management policy.
Methods:Relevant articles from January 2020 to December 2022 were identified through an electronic database search.Meta-analyses were performed using fixed- or random-effects models. Study heterogeneity was assessed using the Q-test and I² test. Publication bias was evaluated using funnel plots and Egger’s and Begg’s tests.
Results:Of 104 studies (103,778 participants), the mean transfusion rate was 16.20%. Korea’s rate (9.72%) was lower than Western (14.97%) and other Eastern nations (18.61%). Although open surgery rates were alike (approximately 25%) globally, Korea’s minimally invasive surgery rate was lower (6.28% vs. ≥10%). Odds ratios (ORs) indicated a higher transfusion risk in open surgeries than minimally invasive surgery, especially in Korea (8.82; 95% confidence interval [CI], 5.55–14.02) compared to other Eastern (OR, 2.57) and Western countries (OR, 2.20). For liver resections due to hepatocellular carcinoma and benign diseases, Korea’s rates (10.86% and 15.62%) were less than in Eastern (18.90% and 29.81%) and Western countries (20.15% and 25.22%).
Conclusion:Korea showed a lower transfusion rate during liver resection than other countries. In addition to the patient’s characteristics, including diagnosis and surgical methods, differences in the medical environment affect blood transfusion rates during liver resection.
