Impact of anaemia at discharge following colorectal cancer surgery
- PDF / 823,301 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 94 Downloads / 160 Views
ORIGINAL ARTICLE
Impact of anaemia at discharge following colorectal cancer surgery Rebecca C. Dru 1,2 & Nathan J. Curtis 1,3 & Emma L. Court 1 & Catherine Spencer 1 & Sara El Falaha 1 & Godwin Dennison 1 & Richard Dalton 1 & Andrew Allison 1 & Jonathan Ockrim 1 & Nader K. Francis 1,4,5 Accepted: 15 April 2020 # The Author(s) 2020
Abstract Objectives Preoperative anaemia is common in patients with colorectal cancer and increasingly optimised prior to surgery. Comparably little attention is given to the prevalence and consequences of postoperative anaemia. We aimed to investigate the frequency and short- or long-term impact of anaemia at discharge following colorectal cancer resection. Methods A dedicated, prospectively populated database of elective laparoscopic colorectal cancer procedures undertaken with curative intent within a fully implemented ERAS protocol was utilised. The primary endpoint was anaemia at time of discharge (haemoglobin (Hb) < 120 g/L for women and < 135 g/L for men). Patient demographics, tumour characteristics, operative details and postoperative outcomes were captured. Median follow-up was 61 months with overall survival calculated with the KaplanMeier log rank method and Cox proportional hazard regression based on anaemia at time of hospital discharge. Results A total of 532 patients with median 61-month follow-up were included. 46.4% were anaemic preoperatively (cohort mean Hb 129.4 g/L ± 18.7). Median surgical blood loss was 100 mL (IQR 0–200 mL). Upon discharge, most patients were anaemic (76.6%, Hb 116.3 g/L ± 14, mean 19 g/L ± 11 below lower limit of normal, p < 0.001). 16.7% experienced postoperative complications which were associated with lower discharge Hb (112 g/L ± 12 vs. 117 g/L ± 14, p = 0.001). Patients discharged anaemic had longer hospital stays (7 [5–11] vs. 6 [5–8], p = 0.037). Anaemia at discharge was independently associated with reduced overall survival (82% vs. 70%, p = 0.018; HR 1.6 (95% CI 1.04–2.5), p = 0.034). Conclusion Anaemia at time of discharge following elective laparoscopic colorectal cancer surgery and ERAS care is common with associated negative impacts upon short-term clinical outcomes and long-term overall survival. Keywords Anaemia . Postoperative . Colorectal cancer . Outcomes
Previous presentations This study has been presented in part to the ERAS World Congress, Liverpool, 1–3 May 2019, British Blood Transfusion Society Annual Conference 18–20 September 2019 and United European Gastroenterology Week 19–23 October 2019. An abstract has been published in Clinical Nutrition ESPEN: https://doi.org/10. 1016/j.clnesp.2019.03.077. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00384-020-03611-0) contains supplementary material, which is available to authorized users. * Nader K. Francis [email protected]; https://orcid.org0000-0001-8498-9175 1
Department of General Surgery, Yeovil District Hospital, Higher Kingston, Yeovil, Somerset BA21 4AT, UK
2
University Hospitals Bristol NHS Foundation Trust,
Data Loading...
