Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Ottawa, 1053, Carling Avenue, Ottawa, ON, K1Y 4E9, Canada.
Division of Obstetrics and Gynecology, University of Sherbrooke, Sherbrooke, QC, Canada.
Int Urogynecol J. 2022 Jul;33(7):1827-1831. doi: 10.1007/s00192-021-04800-3. Epub 2021 Apr 24.
Preoperative anemia is a well-established risk factor for adverse perioperative outcomes in major surgery, but studies exploring complications after pelvic reconstructive surgery are limited. The objective of this study is to examine the impact of preoperative anemia on 30-day adverse outcomes in patients undergoing pelvic organ prolapse surgery.
A retrospective cohort of women undergoing pelvic organ prolapse surgery was captured from the National Surgery Quality Improvement Program database (2014-2019). The primary outcome was a composite of postoperative medical complications such as pulmonary embolism, acute renal failure, stroke, myocardial infarction, cardiac arrest, deep vein thrombosis, and sepsis. Secondary outcomes included surgical site infection, bleeding requiring blood transfusion, readmission within 7 days of surgery, and return to the operating room within 30 days. Multivariate logistic regression was used to adjust for important pre-specified potential confounders.
A total of 50,848 women were included in the analysis and 9.9% (4,579) met the criteria for anemia (hematocrit <36%). Potentially serious medical complications were rare, occurring in only 348 women (0.7%), and were more common among anemic patients (1.1% vs 0.6%, p < 0.001). On multivariate analysis, preoperative anemia was associated with higher odds of both potentially serious medical complications (OR 1.38, 95% CI 1.01-1.88) and returning to the operating room (OR 1.55, 95% CI 1.23-1.94). Anemic patients had a four-fold increase in the odds of requiring a blood transfusion (OR 4.47, 95% CI 3.60-5.56).
Preoperative anemia is associated with an increased risk of adverse postoperative outcomes in women having surgery for pelvic organ prolapse.
术前贫血是重大手术围手术期不良结局的一个公认的危险因素，但研究骨盆重建手术后并发症的研究有限。本研究的目的是探讨术前贫血对接受盆腔器官脱垂手术患者 30 天不良结局的影响。
从国家手术质量改进计划数据库（2014-2019 年）中捕获了接受盆腔器官脱垂手术的女性回顾性队列。主要结局是术后医疗并发症的综合指标，如肺栓塞、急性肾衰竭、中风、心肌梗死、心脏骤停、深静脉血栓形成和败血症。次要结局包括手术部位感染、需要输血的出血、术后 7 天内再次入院和 30 天内返回手术室。多变量逻辑回归用于调整重要的预先指定的潜在混杂因素。
共纳入 50848 名女性进行分析，其中 9.9%（4579 名）符合贫血标准（血细胞比容<36%）。潜在严重的医疗并发症很少见，仅发生在 348 名女性（0.7%）中，且在贫血患者中更为常见（1.1%比 0.6%，p<0.001）。多变量分析显示，术前贫血与潜在严重医疗并发症（OR 1.38，95%CI 1.01-1.88）和返回手术室（OR 1.55，95%CI 1.23-1.94）的可能性更高相关。贫血患者需要输血的可能性增加了四倍（OR 4.47，95%CI 3.60-5.56）。
术前贫血与接受盆腔器官脱垂手术女性的术后不良结局风险增加相关。
