Retrospective evaluation of anaemia and transfusion rate in lower abdominal oncological surgery

Abstract

Background: Anemia is currently considered a contraindication to elective surgery, requiring diagnostic investigations and preoperative iron administration. In the oncological patient, severe anemia can increase tumor aggression and blood transfusion can induce immunosuppression, favouring cancer recurrence and metastatic rate. Objectives: To evaluate the prevalence of anemia and the perioperative transfusion rate in major abdominal-pelvic oncology surgery. Material and methods: Data of all consecutive surgical patients admitted to the ICU during 01-07.2017 were retrospectively analyzed. Patients with major lower digestive, gynecological and urological surgery were selected. Investigated parameters were - demographic data, hemoglobin (preoperative Hb1, postoperative Hb2, at dischargeHb3), anemia prevalence and perioperative transfusion rate. Statistical analysis used t-student, chi-square and ANOVA from SPSS 17. Results: Of a total 1284 patients, n = 546 patients undergoing lower abdominal surgery were enrolled in the study, mean age 60.9 (+/- 12.6) years. The mean hemoglobin Hb1/Hb2/Hb3 values were 12.4/10.6/10.5g/dL. The prevalence of anemia was 38.5% (n = 210) preoperatively, 85.9% (n = 469) postoperatively and 86.9% (n = 474) at discharge. The transfusion rate was 16.6% (n = 91), transfusion index = 2. Comparative analysis showed a higher prevalence of preoperative anemia (50.5vs21.8%, p <0.001) and transfusion rate (21.8vs 1.6%, p <0.01) in lower abdominal versus uro- gynecologic surgery. Conclusions: The analysis of surgical oncology patients with lower abdominal interventions identified an increased prevalence of anemia in all perioperative stages. Acknowledgments – The database used in this study was created by the Patient Blood Management Romanian Group for the internal audit on the prevalence of anemia and transfusion.