Andreea-Iuliana Ceanga1, Mihai Ceanga2, Maria Eveslage3, Edwin Herrmann4, Dania Fischer5, Axel Haferkamp6, Maria Wittmann7, Stefan Müller8, Hugo Van Aken1, Andrea Ulrike Steinbicker9. 1. Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Muenster, Germany. 2. Department of Neurology, University Hospital Muenster, Muenster, Germany. 3. Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany. 4. Department of Urology, University Hospital Muenster, Muenster, Germany. 5. Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Frankfurt, Frankfurt, Germany. 6. Department of Urology, University Hospital Mainz, Mainz, Germany. 7. Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Bonn, Bonn, Germany. 8. Department of Urology, University Hospital Bonn, Bonn, Germany. 9. Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Muenster, Germany. Electronic address: andrea.steinbicker@ukmuenster.de.
Abstract
BACKGROUND: Preoperative anemia and allogeneic blood transfusions (ABTs) may affect outcomes in cancer surgery. The prevalence of anemia, the use of ABTs, the risks of transfusions, lengths of stay and mortality of oncological patients undergoing radical cystectomy were investigated in three University Hospitals in Germany. PATIENTS AND METHODS: Hospital records of 220 consecutive patients undergoing radical cystectomy from 2010 to 2012 were retrospectively analyzed for independent risk factors of ABT and unfavorable outcomes (readmission, increased length of stay (LOS) or death) using multivariate regression analysis. RESULTS: Preoperative anemia was present in 40%. 70% of patients received blood transfusions. Low preoperative and intraoperative nadir hemoglobin levels were associated with receipt of ABT (OR 1.33, P = 0.04 and OR 2.94, P < 0.001 respectively). Transfusion of ten or more red blood cell units (RBCs) during the entire hospital stay was a predictor of an increased LOS (P < 0.001) and death (OR 52, 95%CI [5.9, 461.3], P < 0.001), compared to non-transfused patients. Preoperative ABT and ASA scores were associated with ≥10RBCs. CONCLUSION: Anemic patients undergoing radical cystectomy had a high risk to receive ABTs. Preoperative transfusions and transfusion of ≥10RBCs during the entire hospital stay may increase patient`s mortality. Prospective, randomized controlled studies have to follow this study.
BACKGROUND: Preoperative anemia and allogeneic blood transfusions (ABTs) may affect outcomes in cancer surgery. The prevalence of anemia, the use of ABTs, the risks of transfusions, lengths of stay and mortality of oncological patients undergoing radical cystectomy were investigated in three University Hospitals in Germany. PATIENTS AND METHODS: Hospital records of 220 consecutive patients undergoing radical cystectomy from 2010 to 2012 were retrospectively analyzed for independent risk factors of ABT and unfavorable outcomes (readmission, increased length of stay (LOS) or death) using multivariate regression analysis. RESULTS: Preoperative anemia was present in 40%. 70% of patients received blood transfusions. Low preoperative and intraoperative nadir hemoglobin levels were associated with receipt of ABT (OR 1.33, P = 0.04 and OR 2.94, P < 0.001 respectively). Transfusion of ten or more red blood cell units (RBCs) during the entire hospital stay was a predictor of an increased LOS (P < 0.001) and death (OR 52, 95%CI [5.9, 461.3], P < 0.001), compared to non-transfused patients. Preoperative ABT and ASA scores were associated with ≥10RBCs. CONCLUSION:Anemicpatients undergoing radical cystectomy had a high risk to receive ABTs. Preoperative transfusions and transfusion of ≥10RBCs during the entire hospital stay may increase patient`s mortality. Prospective, randomized controlled studies have to follow this study.
Authors: Elke Schmitt; Patrick Meybohm; Vanessa Neef; Peter Baumgarten; Alexandra Bayer; Suma Choorapoikayil; Patrick Friederich; Jens Friedrich; Christof Geisen; Erdem Güresir; Matthias Grünewald; Martin Gutjahr; Philipp Helmer; Eva Herrmann; Markus Müller; Diana Narita; Ansgar Raadts; Klaus Schwendner; Erhard Seifried; Patrick Stark; Andrea U Steinbicker; Josef Thoma; Markus Velten; Henry Weigt; Christoph Wiesenack; Maria Wittmann; Kai Zacharowski; Florian Piekarski Journal: Acta Neurochir (Wien) Date: 2022-02-26 Impact factor: 2.216