胃肠道癌症择期手术患者术前贫血和缺铁。

IF 2 3区 医学 Q3 ONCOLOGY Journal of Surgical Oncology Pub Date : 2024-11-12 DOI:10.1002/jso.27970
Clarissa P Skorupski, Matthew C Cheung, Julie Hallet, Yosuf Kaliwal, Lena Nguyen, Katerina Pavenski, Jesse S Zuckerman, Yulia Lin
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引用次数: 0

摘要

背景和目的:术前贫血会影响术后效果,但其在胃肠道癌症患者中的重要性以及贫血病因的重要性仍不清楚。我们旨在描述术前贫血和缺铁性贫血(IDA)的频率及其对围手术期预后的影响:我们对接受择期胃肠道癌症手术的成年患者进行了一项回顾性队列研究。主要结果是围手术期输注红细胞的发生率。次要结果包括术后 90 天主要发病率、入住重症监护室和 90 天再入院率。为评估术前贫血和IDA与预后之间的关系,进行了多变量分析:55.5%的患者(n = 15 414)术前存在贫血,58.3%的贫血患者缺铁。术前贫血与输注红细胞的风险增加(RR 2.88,95% CI 2.60-3.20)和次要结果密切相关。术前血红蛋白每下降 1 g/dL,围手术期输注红细胞的调整风险就会增加 40% (RR 1.39,95% CI 1.37-1.42):结论:术前贫血很普遍,是导致术后不良预后的一个独立风险因素。术前血红蛋白水平下降会增加输血和不良预后的风险,因此需要进一步研究,以优化术前贫血的可治疗原因(包括 IDA)的管理。
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Preoperative Anemia and Iron Deficiency in Elective Gastrointestinal Cancer Surgery Patients.

Background and objectives: Preoperative anemia can impact postoperative outcomes, but its importance in gastrointestinal cancer patients, and significance of anemia etiology remains unclear. We aimed to characterize the frequency and impact of preoperative anemia, and iron-deficiency anemia (IDA), on perioperative outcomes.

Methods: We performed a retrospective cohort study of adult patients undergoing elective gastrointestinal cancer surgery. The primary outcome was the incidence of perioperative RBC transfusion. Secondary outcomes included 90-day postoperative major morbidity, ICU admission, and 90-day hospital readmission. Multivariable analyses were performed to assess the association between preoperative anemia and IDA and outcomes.

Results: Preoperative anemia was present in 55.5% of patients (n = 15 414), and 58.3% of anemic patients were iron deficient. Preoperative anemia was independently associated with increased risk of RBC transfusion (RR 2.88, 95% CI 2.60-3.20), and secondary outcomes. For every preoperative hemoglobin decrease of 1 g/dL, the adjusted risk of perioperative RBC transfusion increased by 40% (RR 1.39, 95% CI 1.37-1.42).

Conclusion: Preoperative anemia is prevalent, and an independent risk factor for adverse postoperative outcomes. Decreases in preoperative hemoglobin levels elevate the risk of transfusion and adverse outcomes, supporting further study to optimize management of treatable causes of preoperative anemia including IDA.

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来源期刊
CiteScore
4.70
自引率
4.00%
发文量
367
审稿时长
2 months
期刊介绍: The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.
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