Post-operative anemia in children undergoing elective neurosurgery: An analysis of incidence, risk factors, and outcomes.

IF 0.8 Q4 CLINICAL NEUROLOGY
Journal of Neurosciences in Rural Practice Pub Date : 2024-01-01 Epub Date: 2023-08-12 DOI:10.25259/JNRP_338_2023
Shweta Naik, Amruta Nirale, Suparna Bharadwaj, R P Sangeetha, Dhaval Shukla, Sriganesh Kamath
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Abstract

Objectives: Pediatric neurosurgeries carry a considerable risk of intraoperative bleeding and, subsequently, anemia in the post-operative period. Postoperative anemia is often multifactorial with several factors contributing to its occurrence. The present study aims to quantify the incidence of postoperative anemia, identify potential risk factors, and assess the impact of post-operative anemia on clinical outcomes in the pediatric neurosurgery population.

Materials and methods: This was a single-center and retrospective cohort study which included children <18 years of age undergoing elective neurosurgery. The data were extracted from the electronic and physical patient health records. Post-operative anemia was defined for this study as a hemoglobin value below 10 g/dL at any time up to 3 days after surgery.

Results: A total of 300 children were recruited during the study period. The incidence of post-operative anemia after elective pediatric neurosurgery was 21.33%. Children in the post-operative anemia group were younger (P = 0.004), had lower pre-operative hemoglobin values (P < 0.001), belonged to higher American Society of Anesthesiologists (ASA) physical status (P = 0.023), underwent predominantly supratentorial (P = 0.041) and non-tumor surgeries (0.004), and received lesser intraoperative blood transfusion (P = 0.010) compared to no post-operative anemia group. The factors that remained predictive of post-operative anemia on multivariate analysis were ASA physical status (P = 0.018, odds ratio [OR] = 1.94, 95% confidence interval [CI] of 1.12-3.36), pre-operative hemoglobin (P < 0.001, OR = 0.64, 95% CI of 0.50-0.82), and intraoperative transfusion (P = 0.028, OR = 0.45, 95% CI of 0.22-0.92).

Conclusion: Optimization of modifiable risk factors is essential to reduce the occurrence of post-operative anemia and improve outcomes in pediatric neurosurgical patients.

接受择期神经外科手术的儿童术后贫血:对发生率、风险因素和结果的分析。
目的:小儿神经外科手术有相当大的术中出血风险,因此术后会出现贫血。术后贫血往往是多因素造成的,有多种因素导致贫血的发生。本研究旨在量化小儿神经外科术后贫血的发生率,确定潜在的风险因素,并评估术后贫血对临床结果的影响:这是一项包括儿童在内的单中心回顾性队列研究:研究期间共招募了 300 名儿童。小儿神经外科择期手术后贫血的发生率为 21.33%。与无术后贫血组相比,术后贫血组患儿年龄更小(P = 0.004)、术前血红蛋白值更低(P < 0.001)、美国麻醉医师协会(ASA)体能状态更高(P = 0.023)、主要接受幕上手术(P = 0.041)和非肿瘤手术(0.004)、术中输血量更少(P = 0.010)。在多变量分析中,仍可预测术后贫血的因素包括 ASA 身体状况(P = 0.018,比值比 [OR] = 1.94,95% 置信区间 [CI] 为 1.12-3.36)、术前血红蛋白(P < 0.001,OR = 0.64,95% CI 为 0.50-0.82)和术中输血(P = 0.028,OR = 0.45,95% CI 为 0.22-0.92):优化可改变的风险因素对于减少小儿神经外科患者术后贫血的发生和改善预后至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.10
自引率
0.00%
发文量
129
审稿时长
22 weeks
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