在选择性胃肠道癌症手术患者中患有手术前贫血和铁缺乏症
Clarissa P Skorupski1, Matthew C Cheung1,2,3, Julie Hallet1,3,4
1Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Journal of surgical oncology
|November 12, 2024
概括
在胃肠道癌症手术患者中,术前贫血很常见,并显著增加了输血和不良结果的风险. 治疗贫血,特别是缺铁性贫血,对于更好的手术结果至关重要.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 麻醉学 麻醉学
背景情况:
- 手术前贫血是不良手术结果的已知危险因素.
- 它的流行率和特定影响,包括铁缺乏性贫血 (IDA) 在胃肠道癌症患者中的作用,仍未得到充分研究.
研究的目的:
- 在接受选择性胃肠癌手术的患者中确定手术前贫血和缺铁贫血 (IDA) 的频率.
- 评估手术前贫血和IDA对术后结局的影响,包括红细胞 (RBC) 输血,发病率和再录取.
主要方法:
- 对接受选择性胃肠癌手术的成年患者进行了回顾性队列研究.
- 对术后结果的分析,包括红细胞输血,90天主要发病率,ICU入院和90天重入院.
- 多变量分析以评估手术前贫血/IDA与结果之间的关联.
主要成果:
- 在15414名患者中,55.5%患有手术前贫血.
- 在贫血患者中,58.3%患有铁缺乏症.
- 贫血独立增加了红细胞输血 (RR 2.88) 和其他不良结果的风险. 每降低血红蛋白1g/dL,输血风险就会增加40% (RR1.39).
结论:
- 术前贫血在胃肠道癌症手术患者中非常普遍,是不良术后结果的独立风险因素.
- 术前血红蛋白水平较低与输血风险增加和结果较差相关.
- 优化对手术前贫血可治疗原因的管理,如IDA,需要进一步调查.
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