Preoperative leukopenia does not affect outcomes in cancer patients undergoing elective and emergent abdominal
Heather M Grant1, Lindy L Davis2, Jane Garb1
1Department of Surgery, University of Massachusetts Medical School - Baystate Medical Center, Springfield, MA, USA.
Background:
Leukopenic patients have historically been considered poor surgical candidates due to a perceived increase in operative morbidity and mortality.
Methods:
Retrospective cohort study using the NSQIP database to identify adult patients who received chemotherapy for malignancy within 30-days prior to elective or emergent abdominal surgery between 2008 and 2011. Leukopenia was defined as < 4000 WBC/mm3 within 2-days prior to surgery. Multiple logistic regression assessed if leukopenia was associated with morbidity and mortality.
Results:
Of the 4369 patients included, 20.2% had preoperative leukopenia. Emergency cases comprised 36.2% of cases. Overall 30-day mortality was 12.2% and 30-day composite morbidity was 29.8%. After controlling for significant confounders, including emergency status, leukopenia was not significantly associated with either postoperative mortality (p = 0.14) or morbidity (p = 0.17).
Conclusions:
Our study suggests that in cancer patients undergoing chemotherapy, leukopenia is not associated with morbidity or mortality and should not influence operative planning in either the elective or emergent setting.
