Impact of perioperative hemoglobin levels on postoperative outcomes in gastric cancer surgery

Abstract

Background The aim of this study was to evaluate the association of postoperative blood transfusion and anemia with postoperative outcomes in gastric cancer surgery. Methods We enrolled 588 patients who had undergone curative resection for gastric cancer. Input variables for risk assessment consisted of 3 categories: patient demographics, surgical and pathological factors, and anemia-related factors. Postoperative outcomes included 30-day morbidity and mortality. Univariate and multivariate analyses were performed to identify risk factors influencing postoperative complications. Results The rate of total complications was 19.0 %. Comorbidity, lowest hemoglobin (Hb) level from the operative day up to postoperative day 7 (LOW-Hb), the percentage of drop in Hb level on postoperative day 2 (POD2-Hb change), and postoperative transfusion were independent risk factors in the multivariate analysis, with LOW-Hb and postoperative transfusion found to be the most significant factors. When LOW-Hb was C9.0 g/dL, postoperative complications were higher in the transfused group than in the non-transfused group (60.0 vs. 14.2 %, respectively, p = 0.024), but when LOW-Hb was\9.0 g/dL, postoperative complications were not different between the 2 groups (44.6 vs. 37.5 %, p = 0.525). ConclusionThe lowest postoperative Hb level and postoperative transfusion were the most significant risk factors for postoperative complications in gastric cancer surgery.

The impact of blood transfusion on perioperative outcomes following gastric cancer resection: an analysis of the American College of Surgeons National Surgical Quality Improvement Program database

“…10,11 Only 1 study investigated short-term outcomes, reporting an increased overall 30-day morbidity with RBCT (60% v. 14.2%, p = 0.024) for a sample of 588 patients at a single institution. 13 No morbidity details were presented, such that one cannot decipher the type of complications associated with RBCT. 13 Our large multiinstitutional sample size provides strong evidence of the detrimental effects of RBCT on postoperative outcomes for gastric cancer, for both local and systemic complications.…”

“…13 No morbidity details were presented, such that one cannot decipher the type of complications associated with RBCT. 13 Our large multiinstitutional sample size provides strong evidence of the detrimental effects of RBCT on postoperative outcomes for gastric cancer, for both local and systemic complications. Unplanned reoperations were also associated with RBCT, but this could have been due to postoperative bleeding requiring both RBCT and re-interventions.…”

“…8,9 The current literature looking at the impact of RBCT on gastric cancer surgery is restricted to studies with small sample sizes from individual hospitals. [10][11][12][13] The purpose of the present study was to estimate the effect of RBCT on 30-day postoperative outcomes following elective gastrectomy for gastric cancer using the large multi-institutional American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) data set.…”

Transurethral Resection of the Prostate and Pre-Operative Anemia, in Men Older Than 60 Years

“…The prognostic value of preoperative anaemail in surgical procedures has been examined in many populations of the patients in both cardiac and non-cardiac surgery. In addition, numerous clinical studies, which included a relatively small number of patients who had undergone a particular type of surgical procedure have been conducted (18,22). These examinations have shown that anemia is an independent risk factor for morbidity and mortality in surgical patients (3,4,23), which is the reason why it should be considered a serious medical condition that can be treated (3).…”

“…As for the surgical procedure related factors, the following was analyzed: the main disorder as an indication for the TURP, the type of anaesthesia and surgical operation time. Further factors in relation to anaemail were analyzed: preoperative hemoglobin (Hb) levels in blood, percentage decrease in the Hb level on postoperative day 1 (POD1-Hb change) which indicates the blood loss during the surgical procedure, the mean value of postoperative Hb until the postoperative day 3 and the blood transfusion administration quantity during the hospitalisation (18). The criteria for blood transfusion used at our institution was the transfusion trigger, Hb≤10 g/dL (liberal transfusion strategy) (19).…”