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Preoperative anemia and extensive transfusion during stay-in-hospital are critical for patient`s mortality: A retrospective multicenter cohort study of oncological patients undergoing radical cystectomy
Authors:Andreea-Iuliana Ceanga  Mihai Ceanga  Maria Eveslage  Edwin Herrmann  Dania Fischer  Axel Haferkamp  Maria Wittmann  Stefan Müller  Hugo Van Aken  Andrea Ulrike Steinbicker
Affiliation:1. Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Muenster, Germany;2. Department of Neurology, University Hospital Muenster, Muenster, Germany;3. Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany;4. Department of Urology, University Hospital Muenster, Muenster, Germany;5. Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Frankfurt, Frankfurt, Germany;6. Department of Urology, University Hospital Mainz, Mainz, Germany;7. Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Bonn, Bonn, Germany;8. Department of Urology, University Hospital Bonn, Bonn, Germany
Abstract:

Background

Preoperative anemia and allogeneic blood transfusions (ABTs) may affect outcomes in cancer surgery. The prevalence of anemia, the use of ABTs, the risks of transfusions, lengths of stay and mortality of oncological patients undergoing radical cystectomy were investigated in three University Hospitals in Germany.

Patients and Methods

Hospital records of 220 consecutive patients undergoing radical cystectomy from 2010 to 2012 were retrospectively analyzed for independent risk factors of ABT and unfavorable outcomes (readmission, increased length of stay (LOS) or death) using multivariate regression analysis.

Results

Preoperative anemia was present in 40%. 70% of patients received blood transfusions. Low preoperative and intraoperative nadir hemoglobin levels were associated with receipt of ABT (OR 1.33, P?=?0.04 and OR 2.94, P?

Conclusion

Anemic patients undergoing radical cystectomy had a high risk to receive ABTs. Preoperative transfusions and transfusion of ≥10RBCs during the entire hospital stay may increase patient`s mortality.Prospective, randomized controlled studies have to follow this study.
Keywords:Blood management  RBC transfusion  Cystectomy
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