Diagnosis and treatment status of perioperative anemia in patients with gastrointestinal neoplasms: a multi-center study in Hubei Province.

Peng Zhang; Cong Qing Jiang; Zhi Guo Xiong; Yong Bin Zheng; Ying Feng FU; Xin Ming LI; Dian Fu Pang; Xiao Feng Liao; Xin Tong; Huan Ming Zhu; Zhen Hua Yang; Guang Wei Gong; Xiao Ping Yin; Dong Liang LI; Hong Jun LI; Hong Liu Chen; Xue Feng Jiang; Zhi Jun HE; Yan Jun LU; Xiao Ming Shuai; Jin Bo Gao; Kai Lin Cai; Kai Xiong Tao

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Diagnosis and treatment status of perioperative anemia in patients with gastrointestinal neoplasms: a multi-center study in Hubei Province.

Author: Peng ZHANG ¹ ; Cong Qing JIANG ² ; Zhi Guo XIONG ³ ; Yong Bin ZHENG ⁴ ; Ying Feng FU ⁵ ; Xin Ming LI ⁶ ; Dian Fu PANG ⁷ ; Xiao Feng LIAO ⁸ ; Xin TONG ¹ ; Huan Ming ZHU ⁹ ; Zhen Hua YANG ¹⁰ ; Guang Wei GONG ¹¹ ; Xiao Ping YIN ¹² ; Dong Liang LI ¹³ ; Hong Jun LI ¹⁴ ; Hong Liu CHEN ¹⁵ ; Xue Feng JIANG ¹⁶ ; Zhi Jun HE ¹⁷ ; Yan Jun LU ¹⁸ ; Xiao Ming SHUAI ¹ ; Jin Bo GAO ¹ ; Kai Lin CAI ¹ ; Kai Xiong TAO ¹
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1. Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
2. Department of Colorectal and Anal Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
3. Department Ⅰ of Gastrointestinal Surgery, Hubei Cancer Hospital, Wuhan 430079, China.
4. Department of Gastrointestinal and Anorectal Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China.
5. Department of Gastrointestinal Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China.
6. Department of Gastrointestinal and Anorectal Surgery, Central Hospital of Edong Healthcare Group, Hubei Polytechnic University, Huangshi 435000, China.
7. Department of Gastrointestinal Surgery, Jingzhou Central Hospital, Jingzhou 434020, China.
8. Department of General Surgery, Xiangyang Central Hospital, Hubei College of Liberal Arts and Sciences, Xiangyang 441021, China.
9. Department of Gastrointestinal Surgery, People's Hospital of Macheng, Huanggang 438300, China.
10. Department of Gastiointestinal Surgery, Institute of Digestive Disease, China Three Gorges University, Yichang Central People's Hospital, Yichang 443000, China.
11. Department of Gastrointestinal Surgery, Xiaogan Hospital of Wuhan University of Science and Technology, Xiaogan 432600, China.
12. Department of Gastrointestinal Surgery Ⅱ Ward, Xianning Central Hospital, Hubei University of Science and Technology, Xianning 437100, China.
13. Department of Gastrointestinal Surgery, Xishui People's Hospital, Huanggang 438200, China.
14. Department of General Surgery, the First People's Hospital of Zaoyang, Xiangyang 441200, China.
15. Department of General Surgery, Affiliated Hospital of Hubei Institute for Nationalities, Enshi 445000, China.
16. Department of Gastrointestinal Surgery, the First People's Hospital of Jingzhou, Jingzhou 434000, China.
17. Department of Gastrointestinal Surgery, Renmin Hospital of Hubei University of Medicine, Shiyan 442000, China.
18. Department of Gastrointestinal Surgery, Huanggang Central Hospital, Huanggang 438000, China.
Publication Type:Multicenter Study
MeSH: Adolescent; Adult; Aged; Aged, 80 and over; Anemia/epidemiology*; Blood Transfusion; Female; Gastrointestinal Neoplasms/surgery*; Humans; Length of Stay; Male; Middle Aged; Retrospective Studies; Treatment Outcome; Young Adult
From: Chinese Journal of Surgery 2022;60(1):32-38
CountryChina
Language:Chinese
Abstract: Objective: To investigate the incidence and treatment of perioperative anemia in patients with gastrointestinal neoplasms in Hubei Province. Methods: The clinicopathological data of 7 474 patients with gastrointestinal neoplasms in 62 hospitals in 15 cities (state) of Hubei Province in 2019 were collected in the form of network database. There were 4 749 males and 2 725 females. The median age of the patients was 62 years (range: 17 to 96 years). The hemoglobin value of the first time in hospital and the first day after operation was used as the criterion of preoperative anemia and postoperative anemia. Anemia was defined as male hemoglobin <120 g/L and female hemoglobin <110.0 g/L, mild anemia as 90 to normal, moderate anemia as 60 to <90 g/L, severe anemia as <60 g/L. The t test and χ² test were used for inter-group comparison. Results: The overall incidence of preoperative anemia was 38.60%(2 885/7 474), and the incidences of mild anemia, moderate anemia and severe anemia were 25.09%(1 875/7 474), 11.37%(850/7 474) and 2.14%(160/7 474), respectively. The overall incidence of postoperative anemia was 61.40%(4 589/7 474). The incidence of mild anemia, moderate anemia and severe anemia were 48.73%(3 642/7 474), 12.20%(912/7 474) and 0.47%(35/7 474), respectively. The proportion of preoperative anemia patients receiving treatment was 26.86% (775/2 885), and the proportion of postoperative anemia patients receiving treatment was 14.93% (685/4 589). The proportions of preoperative anemia patients in grade ⅢA, grade ⅢB, and grade ⅡA hospitals receiving treatment were 26.12% (649/2 485), 32.32% (85/263), and 29.93% (41/137), and the proportions of postoperative anemia patients receiving treatment were 14.61% (592/4 052), 22.05% (73/331), and 9.71% (20/206). The proportion of intraoperative blood transfusion (16.74% (483/2 885) vs. 3.05% (140/4 589), χ²=434.555, P<0.01) and the incidence of postoperative complications (17.78% (513/2 885) vs. 14.08% (646/4 589), χ²=18.553, P<0.01) in the preoperative anemia group were higher than those in the non-anemia group, and the postoperative hospital stay in the preoperative anemia group was longer than that in the non-anemia group ((14.1±7.3) days vs. (13.3±6.2) days, t=5.202, P<0.01). Conclusions: The incidence of perioperative anemia in patients with gastrointestinal neoplasms is high. Preoperative anemia can increase the demand for intraoperative blood transfusion and affect the short-term prognosis of patients. At present, the concept of standardized treatment of perioperative anemia among gastrointestinal surgeons in Hubei Province needs to be improved.