Impact of Preoperative Anemia on Outcomes of Enhanced Recovery Program After Colorectal Surgery: A Monocentric Retrospective Study
Impact of Preoperative Anemia on Outcomes of Enhanced Recovery Program After Colorectal Surgery: A Monocentric Retrospective Study
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DOI：
10.1007/s00268-021-06161-w
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发表时间：
2021-05-17
影响因子：
2.6
通讯作者：
Hans, Gregory
中科院分区：
文献类型：
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作者：
Hardy, Pierre-Yves;Degesve, Maxime;Hans, Gregory
贫血在腹部大手术前很常见（35%）。它是术后并发症和住院时间（LOS）延长的独立因素。本研究的目的是评估术前贫血对增强恢复计划（ERP）结果的影响程度。材料与方法对2015年至2019年期间计划进行结直肠手术的患者（n = 494）进行分析。所有患者均采用相同的ERP进行管理。比较贫血和非贫血患者的人口统计学资料、术前危险因素、术后并发症、LOS和ERP依从性。贫血定义为男性血红蛋白浓度< 13 g dL（-1），女性< 12 g dL（-1）。结果和讨论总共有173例患者术前贫血。他们年龄较大（p < 0.001），男性更多（p = 0.02）。以下危险因素在贫血组中明显更常见：肾功能衰竭（p = 0.04）、营养不良（p < 0.001）、心律失常（p < 0.001）、冠状动脉病变（p = 0.02）和抗凝治疗（p < 0.001）。尽管存在更多风险因素，但贫血患者并未出现更多术后并发症（38.2% vs. 31.2%，p = 0.12）。ERP的总体依从性相似（18 [16-19] vs. 18 [17-19]，p = 0.06）。贫血组和非贫血组的LOS分别为4 [3-7]和3 [2-6.25]天（p < 0.002）。多变量分析显示贫血不影响LOS（p = 0.27）。结论术前贫血并不影响择期结直肠手术后ERP的疗效。
Background Anemia is common before major abdominal surgery (35%). It is an independent factor for postoperative complications and longer length of stay (LOS). The aim of this study was to evaluate the extent to which preoperative anemia impacts on enhanced recovery programs (ERP) outcomes. Materials and Methods The data for patients scheduled for colorectal surgery between 2015 and 2019, were analyzed (n = 494). All patients were managed with the same ERP. Demographic data, preoperative risk factors, postoperative complications, LOS and adherence to ERP were compared between anemic and non-anemic patients. Anemia was defined by a hemoglobin concentration < 13 g dL(-1) in men and < 12 g dL(-1) in women. Results and Discussion In total, 173 patients had preoperative anemia. They were older (p < 0.001) and more often male (p = 0.02). The following risk factors were significantly more frequent in the anemic group: renal failure (p = 0.04), malnutrition (p < 0.001), cardiac arrhythmia (p < 0.001), coronaropathy (p = 0.02) and anticoagulant treatment (p < 0.001). Despite more risk factors, anemic patients did not experience more postoperative complications (38.2% vs. 31.2%, p = 0.12). Overall adherence to ERP was similar (18 [16-19] vs. 18 [17-19], p = 0.06). LOS was 4 [3-7] and 3 [2-6.25] days in the anemic and the non-anemic groups, respectively (p < 0.002). Multivariate analysis showed that anemia did not affect LOS (p = 0.27). Conclusion Our study suggests that preoperative anemia does not detract from the benefits of ERP after elective colorectal surgery.