Manejo de la anemia preoperatoria en cáncer colorrectal y análisis de las estrategias perioperatorias Patient Blood Management

Abstract

Introduction and endpoints

Preoperative anaemia is a common finding in patients with colorectal cancer (CRC) and is significantly associated with morbidity and mortality. Patient Blood Management Programs (PBM) have been developed to improve patient outcomes. This study aimed to evaluate the effectiveness of the Outpatient Blood Management Program (OBMP) in a tertiary hospital in Spain. The primary endpoint was to determine the percentage of patients who recover from anaemia after treatment at the OBMP. Additionally, correlations between preoperative anaemia, administered treatments, and surgical waiting times were analyzed.

Methods

A retrospective observational study was conducted including 537 patients who underwent surgical intervention for CRC. Demographic data, haemoglobin values at three time points (inclusion on the surgical waiting list, preoperative, and postoperative), as well as the time intervals between inclusion on the waiting list and the performance of surgery, were collected.

Results

The prevalence of anaemia was 43.3% at the time of inclusion on the surgical waiting list. Of the total anaemic patients, 42% received specific treatment. Treatment at the OBMP was associated with a higher recovery rate (37%) and a more significant increase in haemoglobin (1.35 g/dl IC_95% [0.7-2.1] vs. 0.4 g/dl IC_95% [0-1.6]). Preoperative anaemia was associated with longer surgical waiting times, higher incidence of transfusions, higher prevalence of postoperative anaemia, and prolonged hospital stays.

Conclusion

The OBMP offers an opportunity to improve the management of anaemia in patients undergoing surgery for CRC; however, it requires interdisciplinary coordination to minimize its impact on surgical waiting times.