دورية أكاديمية
Characterization of pre-operative anemia in patients undergoing surgery by a gynecologic oncologist and association with post-operative complications.
العنوان: | Characterization of pre-operative anemia in patients undergoing surgery by a gynecologic oncologist and association with post-operative complications. |
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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.) |
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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 |
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