Association between Intraoperative Blood Loss and Postoperative Outcomes in Colorectal Perforation: A Retrospective Observational Study in Japan.
- 1Department of Trauma and Emergency Surgery, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan.
Abstract
To investigate the association between intraoperative blood loss and postoperative major complications in patients undergoing emergency surgery for colorectal perforation. This single-center retrospective observational study included 138 patients who underwent emergency surgery for colorectal perforation. Patients were classified into two groups based on intraoperative blood loss: ≥200 mL and <200 mL. The primary outcome was major complications defined as Clavien-Dindo grade ≥3 (including in-hospital death). Multivariable logistic regression analysis was performed to identify independent risk factors. Restricted cubic spline analysis was used to assess the dose-response relationship. Major complications occurred in 45 patients (32.6%). Patients with blood loss ≥200 mL had a significantly higher rate of major complications compared with those with blood loss <200 mL (51.5% vs. 15.3%; p < 0.001). Multivariable analysis identified intraoperative blood loss ≥200 mL (adjusted odds ratio [OR], 4.21; 95% confidence interval [CI], 1.75-10.75; p = 0.002) and preoperative hypotension requiring vasopressor use (adjusted OR, 6.70; 95% CI, 2.47-20.01; p < 0.001) as independent risk factors. Restricted cubic spline analysis confirmed a dose-dependent relationship. Intraoperative blood loss ≥200 mL was independently associated with major complications in emergency colorectal perforation surgery. Whether reducing intraoperative blood loss improves postoperative outcomes warrants further investigation.
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BibTeX
@article{yamashita2026association,
title = {{Association between Intraoperative Blood Loss and Postoperative Outcomes in Colorectal Perforation: A Retrospective Observational Study in Japan.}},
author = {Ikutaro Yamashita and Shokei Matsumoto and Masayuki Shimizu},
journal = {Journal of the anus, rectum and colon},
year = {2026},
month = oct,
doi = {10.23922/jarc.2026-056},
url = {https://europepmc.org/article/MED/42952669},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Association between Intraoperative Blood Loss and Postoperative Outcomes in Colorectal Perforation: A Retrospective Observational Study in Japan.
AU - Ikutaro Yamashita
AU - Shokei Matsumoto
AU - Masayuki Shimizu
PY - 2026
DA - 2026/10/25
JO - Journal of the anus, rectum and colon
DO - 10.23922/jarc.2026-056
UR - https://europepmc.org/article/MED/42952669
AB - To investigate the association between intraoperative blood loss and postoperative major complications in patients undergoing emergency surgery for colorectal perforation. This single-center retrospective observational study included 138 patients who underwent emergency surgery for colorectal perforation. Patients were classified into two groups based on intraoperative blood loss: ≥200 mL and <200 mL. The primary outcome was major complications defined as Clavien-Dindo grade ≥3 (including in-hospital death). Multivariable logistic regression analysis was performed to identify independent risk factors. Restricted cubic spline analysis was used to assess the dose-response relationship. Major complications occurred in 45 patients (32.6%). Patients with blood loss ≥200 mL had a significantly higher rate of major complications compared with those with blood loss <200 mL (51.5% vs. 15.3%; p < 0.001). Multivariable analysis identified intraoperative blood loss ≥200 mL (adjusted odds ratio [OR], 4.21; 95% confidence interval [CI], 1.75-10.75; p = 0.002) and preoperative hypotension requiring vasopressor use (adjusted OR, 6.70; 95% CI, 2.47-20.01; p < 0.001) as independent risk factors. Restricted cubic spline analysis confirmed a dose-dependent relationship. Intraoperative blood loss ≥200 mL was independently associated with major complications in emergency colorectal perforation surgery. Whether reducing intraoperative blood loss improves postoperative outcomes warrants further investigation.
SN - 2432-3853
ER -