Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.
Center of Ear, Nose, and Throat Diseases, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania.
Laryngoscope. 2022 Sep;132(9):1707-1713. doi: 10.1002/lary.29893. Epub 2021 Oct 13.
OBJECTIVES/HYPOTHESIS: Preoperative anemia has been shown to be a predictor of complications in different surgeries. This has not been exclusively studied in skull base surgery. This study investigates the impact of preoperative hematocrit on complications following ventral skull base (VSB) surgery.
Retrospective database review.
The National Surgical Quality Improvement Program was queried for all cases of VSB surgery from 2005 to 2015. Univariate and multivariate analyses were performed to investigate the impact of preoperative anemia on complications following VSB procedures.
3,053 patients meeting inclusion criteria were identified. On univariate analysis, low hematocrit was found in 39.7% of patients and was associated with increased mean age (55.71 vs. 53.25 years), male gender (63.6% vs. 36.4%), and Black race (18.5% vs. 10.9%). Preoperative anemia was also associated with increased incidences of postoperative pneumonia, blood transfusions, sepsis, medical complications, surgical complications, extended length of hospital stay (LOS), and mortality. On multivariate analysis, associations between low preoperative hematocrit and perioperative transfusions (odds ratio [OR] 2.57, 95% confidence interval [CI] 1.88-3.50, P < .001), total surgical complications (OR 2.12, 95% CI 1.60-2.80, P < .001), and extended LOS (OR 1.29, 95% CI 1.05-1.57, P = .013) remained significant.
Low preoperative hematocrit is associated with increased risk of postoperative complications and extended LOS in patients undergoing VSB surgery. This study highlights the importance of careful preoperative assessment and management of anemia in these patients.
3 Laryngoscope, 132:1707-1713, 2022.
目的/假设：术前贫血已被证明是多种手术并发症的预测因素。但这一现象尚未在颅底外科中得到专门研究。本研究旨在调查术前血细胞比容对颅底前下部（VSB）手术后并发症的影响。
回顾性数据库研究。
2005 年至 2015 年，国家外科质量改进计划对所有 VSB 手术病例进行了查询。进行单变量和多变量分析，以研究术前贫血对 VSB 手术后并发症的影响。
确定了 3053 名符合纳入标准的患者。单变量分析发现，39.7%的患者存在低血细胞比容，且与平均年龄较大（55.71 岁 vs. 53.25 岁）、男性（63.6% vs. 36.4%）和黑种人（18.5% vs. 10.9%）有关。术前贫血也与术后肺炎、输血、脓毒症、医疗并发症、手术并发症、住院时间延长（LOS）和死亡率增加有关。多变量分析显示，低术前血细胞比容与围手术期输血（比值比 [OR] 2.57，95%置信区间 [CI] 1.88-3.50，P<.001）、总手术并发症（OR 2.12，95% CI 1.60-2.80，P<.001）和 LOS 延长（OR 1.29，95% CI 1.05-1.57，P=.013）显著相关。
术前低血细胞比容与 VSB 手术患者术后并发症和 LOS 延长的风险增加相关。本研究强调了在这些患者中仔细评估和管理贫血的重要性。
3 级喉镜，132：1707-1713，2022 年。
