Papel predictor de la hemoglobina en la morbimortalidad en pacientes intervenidos de cáncer colorrectal
BACKGROUND: Colorectal cancer (CRC) is the third most diagnosed cancer worldwide, with a prevalence of 10.0 %. In cancer patients undergoing tumour resection surgery, preoperative anaemia is the most common condition. OBJECTIVE: The aim of this study is to assess the prevalence of preoperative anaem...
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| Tipo de recurso: | tesis doctoral |
| Estado: | Versión publicada |
| Fecha de publicación: | 2025 |
| País: | España |
| Institución: | Universidad de Valladolid |
| Repositorio: | UVaDOC. Repositorio Documental de la Universidad de Valladolid |
| OAI Identifier: | oai:uvadoc.uva.es:10324/77731 |
| Acceso en línea: | https://doi.org/10.35376/10324/77731 https://uvadoc.uva.es/handle/10324/77731 |
| Access Level: | acceso abierto |
| Palabra clave: | Cáncer colorrectal Anaemia Anemia Colon cancer Cáncer de colon Mortality Mortalidad Patient Blood Management Gestión de sangre del paciente 32 Ciencias Médicas |
| Sumario: | BACKGROUND: Colorectal cancer (CRC) is the third most diagnosed cancer worldwide, with a prevalence of 10.0 %. In cancer patients undergoing tumour resection surgery, preoperative anaemia is the most common condition. OBJECTIVE: The aim of this study is to assess the prevalence of preoperative anaemia and its impact on patients undergoing colorectal surgery and to attempt to establish a cut-off point for increased perioperative morbidity and mortality in a large prospective single centre cohort. METHODS: Retrospective cohort study of 1105 patients between January 2014 to December 2021. Anaemia was defined according to the 1968 WHO criteria. Descriptive analysis of the sample was performed. Multivariate logistic regression analysis was performed using the "enter" method. Survival curves were constructed using the Kaplan-Meier method. The statistical significance level was set at <0.05. RESULTS: In our sample of 1105 patients, 501 (45.3%) were anaemic. Values of Hb 11.85 g.dL-1 are associated with the need for transfusion during surgery and values of Hb 12.05 g.dL-1 in the postoperative period. It’s also associated with the presence of admission complications such as renal or respiratory failure. Preoperative anaemia and WHO anaemia severity staging was associated with a higher incidence of complications (OR 2.76, 95% CI 1.26-6.04, p=0.011). A moderate-severe anaemia is significantly associated with the presence of complications compared to the group without anaemia (OR 3.77, 95% CI 1.52-9.37, p<0.004) and had significantly worse odds ratios (70%) compared with those with mild or no preoperative anaemia (75% vs 87%, p<0.001; respectively). The odds of survival two years after surgery were significantly lower in the group who required a blood transfusion than in those who did not (91% vs 78%, p<0.001). The odds of survival two years after surgery were significantly lower in the group who required a blood transfusion than in those who did not (91% vs 78%, p < 0.001). DISCUSSION/CONCLUSIONS: Anaemia, even mild anaemia, is associated with higher rates of complications, hospitalisation, and mortality. Our study shows that an Hb level of less than 11.65 g dL-1 was associated with increased in-hospital mortality and a level of 12.05 g dL-1 or less was associated with increased mortality after discharge. Value of at least 13 should be considered as the optimal preoperative Hb threshold. |
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