术后贫血与选择性结肠直肠癌手术后的长期术后不良结果有关。

IF 0.8 Q3 ANESTHESIOLOGY

Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-04-10 DOI:10.1016/j.redar.2024.501724

J. Ripollés-Melchor , A. Abad-Motos , M.L. Fuenmayor Valera , A. Ruiz-Escobar , A. Abad-Gurumeta , G. Paseiro-Crespo , P. Fernández-Valdés-Bango , A. León-Bretscher , P. Soto-García , C. Jericó-Alba , J.A. García-Erce

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引用次数: 0

摘要

背景：贫血是腹部大手术围手术期预后不良的独立危险因素，并与非心脏手术后30天死亡率增加相关。目的调查在一个有完善的术后增强恢复（ERAS）计划的中心进行的结直肠肿瘤手术后贫血的发生率和短期和长期生存率。方法：我们对2013年至2017年在我院ERAS通路内接受选择性结直肠肿瘤手术的所有患者进行了回顾性队列研究。基于出院时贫血，采用Kaplan-Meier对数秩法和Cox比例风险回归计算总生存率。结果共纳入患者680例。出院时贫血的患者5年总生存率较低（53.9% vs. 44%, p 0.05）。出院时贫血的患者5年总生存率较低(危险比[HR] 95% CI 2.663 [1.619-4.379], p <；0.001)。在术前、术后和RBC联合输血模型中，Kaplan-Meier生存率和Cox回归比例风险生存率为1.55 (1.038 2.318)p = 0.032。结论术前贫血、术后贫血和输血的综合预后价值使患者不能存活5年的风险增加40.7%。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

La anemia postoperatoria está asociada a malos resultados postoperatorios a largo plazo tras la cirugía oncológica colorrectal electiva dentro de una ruta ERAS

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La anemia postoperatoria está asociada a malos resultados postoperatorios a largo plazo tras la cirugía oncológica colorrectal electiva dentro de una ruta ERAS

Background

Anaemia is an independent risk factor for poor perioperative outcomes after major abdominal surgery, and is associated with an increased risk of 30-day postoperative mortality after noncardiac surgery.

Objective

To investigate the frequency of postoperative anaemia and short- and long-term survival after colorectal oncologic surgery at a centre with a well-established Enhanced Recovery After Surgery (ERAS) program.

Methods

We conducted a retrospective cohort study of all patients undergoing elective colorectal oncologic surgery within an ERAS pathway at our institution between 2013 and 2017. Overall survival was calculated with the Kaplan-Meier log rank method and Cox proportional hazard regression based on anaemia at hospital discharge.

Results

A total of 680 patients were included. Patients with anaemia at discharge showed a lower overall survival at 5 years (53.9% vs. 44%, p 0.05). Patients who were anaemic at discharge had a lower 5-year overall survival (hazard ratio [HR] 95% CI 2.663 [1.619-4.379], p < 0.001). Kaplan-Meier survival and Cox regression proportional hazard survival for overall survival in the combined preoperative, postoperative, and RBC transfusion model were 1.55 (1.038 2.318) p = 0.032.

Conclusions

The combined prognostic value of preoperative anaemia, postoperative anaemia, and blood transfusion created a 40.7% higher risk of not surviving 5 years.

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