Perioperative Blood Management of Preoperative Anemia Determines Long-Term Outcome in Patients with Pancreatic Surgery

Perioperative Blood Management of Preoperative Anemia Determines Long-Term Outcome in Patients with Pancreatic Surgery

Background/Purpose Anemia affects the postoperative course of patients undergoing a major surgical procedure. However, it remains unclear whether anemia has a different impact on the long-term outcome of patients with malignant or benign pancreatic disease. Methods A retrospective analysis of patien...

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Bibliographic Details
Published in:Journal of gastrointestinal surgery Vol. 25; no. 10; pp. 2572 - 2581
Main Authors: Oehme, F., Hempel, S., Knote, R., Addai, D., Distler, M., Muessle, B., Bork, U., Weitz, J., Welsch, T., Kahlert, C.
Format: Journal Article
Language:English
Published: New York Springer US 01-10-2021
Springer Nature B.V
Subjects:
Anemia
Anemia - complications
Blood Transfusion
Blood transfusions
Digestive System Surgical Procedures
Gastroenterology
Humans
Medical prognosis
Medicine
Medicine & Public Health
Multivariate analysis
Original Article
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Retrospective Studies
Risk Factors
Surgery
Long-term survival
Transfusion
Pancreatic surgery
Anemia
Pancreatic disease
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Summary:Background/Purpose Anemia affects the postoperative course of patients undergoing a major surgical procedure. However, it remains unclear whether anemia has a different impact on the long-term outcome of patients with malignant or benign pancreatic disease. Methods A retrospective analysis of patients undergoing pancreatic surgery for pancreatic malignancies or chronic pancreatitis was conducted between January 2012 and June 2018 at the University Hospital Dresden, Germany. The occurrence of preoperative anemia and the administration of pre-, intra-, and postoperative blood transfusions were correlated with postoperative complications and survival data by uni- and multivariate analysis. Results A total of 682 patients were included with 482 (70.7%) undergoing surgical procedures for pancreatic malignancies. Univariate regression analysis confirmed preoperative anemia as a risk factor for postoperative complications > grade 2 according to the Clavien-Dindo classification. Multivariate regression analyses indicated postoperative blood transfusion as an independent risk factor for postoperative complications in patients with a benign (OR 20.5; p value < 0.001) and a malignant pancreatic lesion (OR 4.7; p value < 0.01). Univariate and multivariate analysis revealed preoperative anemia and pre-, intra-, and postoperative blood transfusions as independent prognostic factors for shorter overall survival in benign and malignant patients ( p value < 0.001–0.01). Conclusion Preoperative anemia is a prevalent, independent, and adjustable factor in pancreatic surgery, which poses a significant risk for postoperative complications irrespective of the entity of the underlying disease. It should therefore be understood as an adjustable factor rather than an indicator of underlying disease severity.
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ISSN:1091-255X
1873-4626
DOI:10.1007/s11605-021-04917-2