术前贫血与食管癌根治术患者住院时间的关系：单中心回顾性研究。
The relationship between preoperative anemia and length of hospital stay among patients undergoing radical surgery for esophageal carcinoma: a single-centre retrospective study.
机构信息
Shantou University Medical College, 22 Xinling Road, Shantou, Guangdong, 515041, China.
Department of Oncology, Graduate Collaborative Training Base of The First People's Hospital of Xiangtan City, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China.
出版信息
BMC Anesthesiol. 2023 Oct 1;23(1):322. doi: 10.1186/s12871-023-02235-5.
BACKGROUND
Although it is unclear if preoperative anemia affects patients undergoing radical resection of esophageal cancer, it does increase the length of stay (LOS) for surgical patients. Accordingly, the purpose of this study was to investigate if, after adjusting for other covariates, anemia was independently associated with LOS in people undergoing radical resection of esophageal cancer.
METHODS
The retrospective cohort study included 680 patients undergoing radical esophageal cancer surgery between January 2010 and December 2020. Preoperative anemia was the targeted independent variable, while LOS was the target independent variable. Demographics, comorbidities, laboratory tests, surgery and anesthesia, postoperative outcomes, and complications were collected. Multivariate linear analyses were performed for variables that might influence preoperative anemia and LOS selection. Subgroup analysis using hierarchical variables was then used to test the potential relationship.
RESULTS
The 647 individuals that were randomly chosen had an average age of 61.06 ± 8.16 years, and 77.43% of them were male. The prevalence of anemia was 36.6%. All patients recruited had an average length of stay (LOS) of 26.31 ± 13.19 days, 25.40 ± 11.44 days for patients who had no preoperative anemia, and 27.89 ± 15.66 days for patients who had preoperative anemia, p < 0.05. After adjusting for covariates, the results of fully adjusted linear regression revealed that preoperative anemia was significantly associated with LOS (β = 2.04, 95%CI (0.13, 3.96) ), p < 0.05. The results of the subgroup analysis were basically accurate and steady. Regardless of gender, same outcomes were seen when preoperative anemia was defined as a Hb level < 13 g/dL (β = 2.29, 95%CI (0.33, 4.25) ), p < 0.05. In addition, the LOS was shortened with the increase of preoperative hemoglobin (Hb) (β= -0.81, 95%CI (-1.46, -0.1) ), p < 0.05.
CONCLUSION
Preoperative anemia is typical in Chinese patients undergoing radical esophageal cancer resection and is independently associated with prolonged LOS.
背景
尽管术前贫血是否会影响接受食管癌根治性切除术的患者尚不清楚，但它确实会增加手术患者的住院时间（LOS）。因此，本研究的目的是调查在调整其他协变量后，贫血是否与接受食管癌根治性切除术的患者的 LOS 独立相关。
方法
本回顾性队列研究纳入了 2010 年 1 月至 2020 年 12 月期间接受根治性食管癌手术的 680 例患者。术前贫血是目标独立变量，而 LOS 是目标独立变量。收集了人口统计学、合并症、实验室检查、手术和麻醉、术后结果和并发症。对可能影响术前贫血和 LOS 选择的变量进行了多变量线性分析。然后使用分层变量进行亚组分析以测试潜在的关系。
结果
随机选择的 647 名患者平均年龄为 61.06±8.16 岁，其中 77.43%为男性。贫血患病率为 36.6%。所有入组患者的平均住院时间（LOS）为 26.31±13.19 天，无术前贫血的患者为 25.40±11.44 天，术前贫血的患者为 27.89±15.66 天，p<0.05。在调整了协变量后，完全调整后的线性回归结果表明，术前贫血与 LOS 显著相关（β=2.04，95%CI（0.13，3.96）），p<0.05。亚组分析的结果基本准确且稳定。无论性别如何，当将术前贫血定义为 Hb 水平<13 g/dL 时，均观察到相同的结果（β=2.29，95%CI（0.33，4.25）），p<0.05。此外，随着术前血红蛋白（Hb）的增加，LOS 缩短（β=-0.81，95%CI（-1.46，-0.1）），p<0.05。
结论
术前贫血在中国接受根治性食管癌切除术的患者中很常见，并且与 LOS 延长独立相关。
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