Surgery in patients with hemoglobin SC disease

L Neumayr, M Koshy, C Haberkern… - American journal of …, 1998 - Wiley Online Library
L Neumayr, M Koshy, C Haberkern, AN Earles, R Bellevue, K Hassell, S Miller, D Black
American journal of hematology, 1998Wiley Online Library
While surgery is commonly required for complications related to hemoglobin SC (HbSC)
disease, little is known about the perioperative complications or the indications for
preoperative transfusion in this group. We describe the patient characteristics, preoperative
transfusion regimens, and outcome in 92 patients with HbSC and sickle‐variants
undergoing elective surgery. Thirty‐eight percent of the patients were transfused
preoperatively. Patients transfused were more likely to have been hospitalized in the year …
Abstract
While surgery is commonly required for complications related to hemoglobin SC (HbSC) disease, little is known about the perioperative complications or the indications for preoperative transfusion in this group. We describe the patient characteristics, preoperative transfusion regimens, and outcome in 92 patients with HbSC and sickle‐variants undergoing elective surgery. Thirty‐eight percent of the patients were transfused preoperatively. Patients transfused were more likely to have been hospitalized in the year prior to the surgery and scheduled for abdominal procedures. Abdominal and ear, nose and throat procedures were the most common surgeries in our study. The overall complication rate was 18% and sickle cell‐related complications occurred in 9% of patients. In patients undergoing intra‐abdominal procedures, the incidence of sickle cell‐related complications was significantly higher in those patients not transfused prior to their surgery (35 vs. 0%). There were two deaths. We recommend selective use of preoperative transfusion in patients with HbSC disease undergoing surgery. Transfusion appears to be beneficial in abdominal cases but is not necessary with minor procedures such as myringtomy. Am. J. Hematol. 57:101–108, 1998. © 1998 Wiley‐Liss, Inc.
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