RT info:eu-repo/semantics/doctoralThesis
T1 Papel predictor de la hemoglobina en la morbimortalidad en pacientes intervenidos de cáncer colorrectal
A1 Herrero García, Alba
A2 Universidad de Valladolid. Escuela de Doctorado
K1 Cáncer colorrectal
K1 Anaemia
K1 Anemia
K1 Colon cancer
K1 Cáncer de colon
K1 Mortality
K1 Mortalidad
K1 Patient Blood Management
K1 Gestión de sangre del paciente
K1 32 Ciencias Médicas
AB BACKGROUND: Colorectal cancer (CRC) is the third most diagnosed cancer worldwide, with a prevalence of 10.0 %. In cancer patients undergoing tumour resection surgery, preoperative anaemia is the most common condition. OBJECTIVE: The aim of this study is to assess the prevalence of preoperative anaemia and its impact on patients undergoing colorectal surgery and to attempt to establish a cut-off point for increased perioperative morbidity and mortality in a large prospective single centre cohort.METHODS: Retrospective cohort study of 1105 patients between January 2014 to December 2021. Anaemia was defined according to the 1968 WHO criteria. Descriptive analysis of the sample was performed. Multivariate logistic regression analysis was performed using the "enter" method. Survival curves were constructed using the Kaplan-Meier method. The statistical significance level was set at <0.05.RESULTS: In our sample of 1105 patients, 501 (45.3%) were anaemic. Values of Hb 11.85 g.dL-1 are associated with the need for transfusion during surgery and values of Hb 12.05 g.dL-1 in the postoperative period. It’s also associated with the presence of admission complications such as renal or respiratory failure. Preoperative anaemia and WHO anaemia severity staging was associated with a higher incidence of complications (OR 2.76, 95% CI 1.26-6.04, p=0.011). A moderate-severe anaemia is significantly associated with the presence of complications compared to the group without anaemia (OR 3.77, 95% CI 1.52-9.37, p<0.004) and had significantly worse odds ratios (70%) compared with those with mild or no preoperative anaemia (75% vs 87%, p<0.001; respectively). The odds of survival two years after surgery were significantly lower in the group who required a blood transfusion than in those who did not (91% vs 78%, p<0.001). The odds of survival two years after surgery were significantly lower in the group who required a blood transfusion than in those who did not (91% vs 78%, p < 0.001). DISCUSSION/CONCLUSIONS: Anaemia, even mild anaemia, is associated with higher rates of complications, hospitalisation, and mortality. Our study shows that an Hb level of less than 11.65 g dL-1 was associated with increased in-hospital mortality and a level of 12.05 g dL-1 or less was associated with increased mortality after discharge. Value of at least 13 should be considered as the optimal preoperative Hb threshold.
YR 2025
FD 2025
LK https://uvadoc.uva.es/handle/10324/77731
UL https://uvadoc.uva.es/handle/10324/77731
LA spa
NO Escuela de Doctorado
DS UVaDOC
RD 03-ene-2026