Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Gastric Cancer. 2013 Jul;16(3):377-82. doi: 10.1007/s10120-012-0196-8. Epub 2012 Sep 25.
The aim of this study was to evaluate the association of postoperative blood transfusion and anemia with postoperative outcomes in gastric cancer surgery.
We enrolled 588 patients who had undergone curative resection for gastric cancer. Input variables for risk assessment consisted of 3 categories: patient demographics, surgical and pathological factors, and anemia-related factors. Postoperative outcomes included 30-day morbidity and mortality. Univariate and multivariate analyses were performed to identify risk factors influencing postoperative complications.
The rate of total complications was 19.0%. Comorbidity, lowest hemoglobin (Hb) level from the operative day up to postoperative day 7 (LOW-Hb), the percentage of drop in Hb level on postoperative day 2 (POD2-Hb change), and postoperative transfusion were independent risk factors in the multivariate analysis, with LOW-Hb and postoperative transfusion found to be the most significant factors. When LOW-Hb was ≥9.0 g/dL, postoperative complications were higher in the transfused group than in the non-transfused group (60.0 vs. 14.2%, respectively, p = 0.024), but when LOW-Hb was <9.0 g/dL, postoperative complications were not different between the 2 groups (44.6 vs. 37.5%, p = 0.525).
The lowest postoperative Hb level and postoperative transfusion were the most significant risk factors for postoperative complications in gastric cancer surgery.
本研究旨在评估胃癌手术后输血和贫血与术后结局的关系。
我们纳入了 588 例接受根治性胃癌切除术的患者。风险评估的输入变量包括 3 类：患者人口统计学、手术和病理因素以及与贫血相关的因素。术后结局包括 30 天发病率和死亡率。进行单因素和多因素分析以确定影响术后并发症的危险因素。
总并发症发生率为 19.0%。合并症、手术日至术后第 7 天的最低血红蛋白（Hb）水平（LOW-Hb）、术后第 2 天（POD2-Hb 变化）Hb 水平下降的百分比以及术后输血是多因素分析中的独立危险因素，其中 LOW-Hb 和术后输血是最显著的因素。当 LOW-Hb≥9.0 g/dL 时，输血组的术后并发症发生率高于非输血组（分别为 60.0%和 14.2%，p=0.024），但当 LOW-Hb<9.0 g/dL 时，两组之间的术后并发症无差异（分别为 44.6%和 37.5%，p=0.525）。
胃癌手术后最低的术后 Hb 水平和术后输血是术后并发症的最显著危险因素。
