دورية أكاديمية
أعرض في EDS

Characterization of pre-operative anemia in patients undergoing surgery by a gynecologic oncologist and association with post-operative complications.

التفاصيل البيبلوغرافية
العنوان: Characterization of pre-operative anemia in patients undergoing surgery by a gynecologic oncologist and association with post-operative complications.
المؤلفون: Foley OW; Obstetrics and Gynecology, Division of Gynecologic Oncology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA olivia.foley@nm.org., Vega B; Obstetrics and Gynecology, Division of Gynecologic Oncology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Roque D; Obstetrics and Gynecology, Division of Gynecologic Oncology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Hinchcliff E; Obstetrics and Gynecology, Division of Gynecologic Oncology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Marcus J; Obstetrics and Gynecology, Division of Gynecologic Oncology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Tanner EJ; Obstetrics and Gynecology, Division of Gynecologic Oncology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Barber EL; Obstetrics and Gynecology, Division of Gynecologic Oncology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
المصدر: International journal of gynecological cancer : official journal of the International Gynecological Cancer Society [Int J Gynecol Cancer] 2023 Nov 06; Vol. 33 (11), pp. 1778-1785. Date of Electronic Publication: 2023 Nov 06.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural
اللغة: English
بيانات الدورية: Publisher: BMJ Country of Publication: England NLM ID: 9111626 Publication Model: Electronic Cited Medium: Internet ISSN: 1525-1438 (Electronic) Linking ISSN: 1048891X NLM ISO Abbreviation: Int J Gynecol Cancer Subsets: MEDLINE
أسماء مطبوعة: Publication: 2019- : [London] : BMJ
Original Publication: Cambridge, MA, USA : Blackwell Scientific Publications, c1991-
مواضيع طبية MeSH: Anemia*/complications , Anemia*/epidemiology , Genital Neoplasms, Female*/surgery , Ovarian Neoplasms*/complications , Oncologists*, Humans ; Female ; Postoperative Complications/etiology ; Risk Factors ; Retrospective Studies
مستخلص: Objective: Anemia is prevalent in patients with gynecologic cancers and is associated with increased peri-operative morbidity. We aimed to characterize risk factors for pre-operative anemia and describe outcomes among patients undergoing surgery by a gynecologic oncologist to identify potential areas for impactful intervention.
Methods: We analyzed major surgical cases performed by a gynecologic oncologist in the National Surgical Quality Improvement Program (NSQIP) database from 2014 to 2019. Anemia was defined as hematocrit <36%. Demographic characteristics and peri-operative variables for patients with and without anemia were compared using bivariable tests. Odds of peri-operative complications in patients stratified by pre-operative anemia were calculated using logistic regression models.
Results: Among 60 017 patients undergoing surgery by a gynecologic oncologist, 23.1% had pre-operative anemia. Women with ovarian cancer had the highest rate of pre-operative anemia at 39.7%. Patients with advanced-stage cancer had a higher risk of anemia than early-stage disease (42.0% vs 16.3%, p≤0.001). In a logistic regression model adjusting for potential demographic, cancer-related, and surgical confounders, patients with pre-operative anemia had increased odds of infectious complications (odds ratio (OR) 1.16, 95% CI 1.07 to 1.26), thromboembolic complications (OR 1.39, 95% CI 1.15 to 1.68), and blood transfusion (OR 5.78, 95% CI 5.34 to 6.26).
Conclusions: There is a high rate of anemia in patients undergoing surgery by a gynecologic oncologist, particularly those with ovarian cancer and/or advanced malignancy. Pre-operative anemia is associated with increased odds of peri-operative complications. Interventions designed to screen for and treat anemia in this population have the potential for significant impact on surgical outcomes.
Competing Interests: Competing interests: ELB received career development funds from the GOG Foundation and the National Institute on Aging (NIA) (1P30AG059988-01a1).
(© IGCS and ESGO 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
References: Am J Surg. 2009 Nov;198(5 Suppl):S19-27. (PMID: 19874930)
JAMA. 2019 Mar 12;321(10):983-997. (PMID: 30860564)
Br J Surg. 2015 Oct;102(11):1314-24. (PMID: 26349842)
JAMA Surg. 2021 Aug 1;156(8):775-784. (PMID: 33881466)
Am J Obstet Gynecol. 2019 Dec;221(6):629.e1-629.e18. (PMID: 31310749)
Gynecol Oncol. 2018 Oct;151(1):141-144. (PMID: 30121133)
J Arthroplasty. 2020 Jun;35(6S):S214-S218. (PMID: 32019689)
Eur J Cancer. 2004 Oct;40(15):2293-306. (PMID: 15454256)
Gynecol Oncol. 2018 Nov;151(2):294-298. (PMID: 30201233)
Can Oncol Nurs J. 2022 Feb 1;32(1):75-80. (PMID: 35280061)
Gynecol Oncol. 2018 Jul;150(1):19-22. (PMID: 29773300)
Acta Obstet Gynecol Scand. 2020 Jan;99(1):112-118. (PMID: 31449328)
Lancet. 2020 Oct 24;396(10259):1353-1361. (PMID: 32896294)
PLoS One. 2016 Nov 15;11(11):e0166635. (PMID: 27846276)
PLoS One. 2015 Jul 06;10(7):e0130861. (PMID: 26147954)
Am J Med. 2004 Apr 5;116 Suppl 7A:11S-26S. (PMID: 15050883)
Clin Epidemiol. 2016 Apr 18;8:61-71. (PMID: 27186078)
Gynecol Oncol. 2015 Apr;137(1):93-7. (PMID: 25617772)
Gynecol Oncol. 2015 Jan;136(1):65-70. (PMID: 25451693)
Surgery. 2016 Oct;160(4):946-953. (PMID: 27544540)
BMC Cancer. 2018 Oct 26;18(1):1041. (PMID: 30367632)
Gynecol Oncol. 2023 Apr;171:76-82. (PMID: 36827841)
J Am Coll Surg. 2009 May;208(5):931-7, 937.e1-2; discussion 938-9. (PMID: 19476865)
J Natl Compr Canc Netw. 2021 Feb 01;19(5):513-520. (PMID: 33524941)
Br J Anaesth. 2014 Sep;113(3):416-23. (PMID: 24829444)
Am J Kidney Dis. 2001 Feb;37(2):300-7. (PMID: 11157370)
Am J Surg. 2013 Dec;206(6):1024-32; discussion 1032-3. (PMID: 24296103)
Gynecol Oncol. 2018 Sep;150(3):446-450. (PMID: 30001834)
Gynecol Oncol. 2017 Feb;144(2):260-265. (PMID: 27908531)
Int J Gynecol Cancer. 2014 May;24(4):779-86. (PMID: 24681712)
Am J Med. 2018 Aug;131(8):972.e1-972.e7. (PMID: 29660351)
Ann Oncol. 2013 Jul;24(7):1886-1892. (PMID: 23567147)
معلومات مُعتمدة: P30 AG059988 United States AG NIA NIH HHS
فهرسة مساهمة: Keywords: Ovarian Cancer; Postoperative complications; Preoperative Care; Surgery
تواريخ الأحداث: Date Created: 20230709 Date Completed: 20231108 Latest Revision: 20240218
رمز التحديث: 20240218
مُعرف محوري في PubMed: PMC10774452
DOI: 10.1136/ijgc-2023-004539
PMID: 37423639
قاعدة البيانات: MEDLINE
الوصف
تدمد:1525-1438
DOI:10.1136/ijgc-2023-004539