Evaluating The Relationship Between Blood Transfusion Time Points and Mortality in Patients with Bladder Cancer Undergoing Radical Cystectomy Navid Masoumi, Hassan Al Chaabi, Ali Jouzi, Mohammad Mehdi Darzi

Radical cystectomy as a crucial treatment approach for high-grade bladder cancer is often associated with substantial blood loss and a frequent necessity for blood transfusion. Investigating the correlation between perioperative blood transfusion and surgical outcomes is an area of contention. We aimed to examine the relationship between blood transfusion timing and mortality in patients undergoing radical cystectomy.

The clinical records of 274 patients who underwent radical cystectomy at Modarres Hospital in Tehran, Iran, during 2011-2021 were reviewed. Among them, 191 patients received perioperative blood transfusions. The 90-day mortality rate was compared between these groups, and the association between transfusion timing and mortality was assessed.

The 90-day mortality rate was 14% in the blood recipient group and 11% in the non-transfusion group. However, no statistically significant relationship was observed between blood transfusion and 90-day mortality (P=0.4). The most prevalent timeframe for blood transfusion was before and during surgery. Mortality was highest in the group receiving blood before and during the operation, with a rate of 18%. Nevertheless, no statistically significant association was found between transfusion timing and mortality (P=0.346). When comparing the Charlson Comorbidity index (CCI) between the two groups, significantly higher CCI levels were observed in the blood recipient group (P=0.003).

In our retrospective review, no significant relationship was identified between blood transfusion, its timing, surgical outcomes, and 90-day mortality. However, the blood recipient group had higher CCI scores compared to non-transfused patients.