Preoperative management of colorectal cancer–induced iron deficiency anemia in clinical practice: data from a large observational cohort

María Jesús Laso-Morales; Carlos Jericó; Susana Gómez-Ramírez; Jordi Castellví; Lorenzo Viso; Inmaculada Roig-Martínez; Caridad Pontes; Manuel Muñoz

doi:10.1111/trf.14278

Preoperative management of colorectal cancer–induced iron deficiency anemia in clinical practice: data from a large observational cohort

María Jesús Laso-Morales, Carlos Jericó, Susana Gómez-Ramírez, Jordi Castellví, Lorenzo Viso, Inmaculada Roig-Martínez, Caridad Pontes, Manuel Muñoz

Producción científica: Contribución a una revista › Artículo › Investigación

45 Citas (Scopus)

Resumen

La prevalencia de la anemia preoperatoria entre pacientes con cáncer colorrectal es alta y puede influir negativamente en el resultado posoperatorio. Este estudio evalúa la eficacia del protocolo para controlar la anemia preoperatoria en pacientes con cáncer colorrectal. DISEÑO Y MÉTODOS DEL ESTUDIO: Se trata de un análisis retrospectivo de resecciones consecutivas por cáncer colorrectal (CCR) realizadas en dos centros españoles entre enero de 2012 y diciembre de 2013. La anemia preoperatoria se definió como una hemoglobina inferior a 13 g/dL, que se trató con hierro intravenoso o atención estándar (hierro oral o sin hierro). El requisito para la transfusión de glóbulos rojos fue la variable principal del resultado. Las infecciones posoperatorias y la duración de la estancia hospitalaria fueron variables secundarias del resultado. Los pacientes se gestionaron mediante un desencadenante restrictivo de la transfusión (Hb < 8 g/dL). La infección se diagnosticó clínicamente y se confirmó con pruebas de laboratorio, microbiológicas o radiológicas. RESULTADOS: En general, 322 de los 571 pacientes (56%) presentaron anemia: 232 recibieron IVI y 90 atención estándar. Se observaron diferencias en la tasa de RBCT entre ausencia de anemia y presencia de anemia (2% frente a 16%; p < 0,01), pero no en las infecciones posoperatorias (19% frente a 22%; p = NS) o duración de la estancia hospitalaria. No se observaron diferencias entre grupos en cuanto a las tasas de RBCT (16% frente a 17%; p = NS), pero las tasas de infección fueron menores entre los pacientes tratados con IVI (18% frente a 29%; p < 0,05). No se registraron efectos secundarios relevantes relacionados con el tratamiento con IVI. CONCLUSIÓN: En comparación con la atención estándar, el tratamiento con IVI fue más eficaz en el tratamiento de la anemia preoperatoria en pacientes con cáncer colorrectal y pareció reducir las tasas de infección, aunque no redujo la RBCT posoperativa.

Idioma original	Inglés
Páginas (desde-hasta)	3040-3048
Publicación	Transfusion
Volumen	57
N.º	12
DOI	https://doi.org/10.1111/trf.14278
Estado	Publicada - 1 ene 2017

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10.1111/trf.14278

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https://www.scopus.com/pages/publications/85027692728

Ferroterapia endovenosa en la optimización de la hemoglobina en el postoperatorio de cirurgía neoplásica colorrectal: : influencia de las pautas posológicas en la tolerabilidad, el cumplimiento terapéutico y la efectividad del tratamiento.
Laso Morales, Maria Jesús (Autor/a), Pontes Garcia, C. (Director/a), Vives Vilagut, R. (Director/a) & Gich Saladich, I. J. (Tutor/a), 11 nov 2019
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@article{a217c858a9be4236a7db17789e86fc3c,

title = "Preoperative management of colorectal cancer–induced iron deficiency anemia in clinical practice: data from a large observational cohort",

abstract = "Preoperative anemia prevalence among colorectal cancer (CRC) patients is high and may adversely influence postoperative outcome. This study assesses the efficacy of a preoperative anemia managing protocol in CRC. STUDY DESIGN AND METHODS: This was a retrospective analysis of consecutive CRC resections at two Spanish centers (January 2012 to December 2013). Preoperative anemia was defined as a hemoglobin (Hb) level of less than 13 g/dL and treated with intravenous iron (IVI) or standard care (oral iron or no iron). Red blood cell transfusion (RBCT) requirements was the primary outcome variable. Postoperative infection rate and length of hospital stay (LOS) were secondary outcome variables. Patients were managed with a restrictive transfusion trigger (Hb < 8 g/dL). Infection was diagnosed clinically and confirmed by laboratory, microbiologic, and/or radiologic evidence. RESULTS: Overall, 322 of 571 patients (56\%) presented with anemia: 232 received IVI and 90 standard care. There were differences in RBCT rate between no anemia and anemia (2\% vs. 16\%; p < 0.01), but not in postoperative infections (19\% vs. 22\%; p = NS) or LOS. Compared to those on standard care, anemic patients on IVI presented with lower Hb (10.8 g/dL vs. 12.0 g/dL; p < 0.001) at baseline, but similar Hb on day of surgery and Postoperative Day 30. There were no between-group differences in RBCT rates (16\% vs. 17\%; p = NS), but infection rates were lower among IVI-treated patients (18\% vs. 29\%; p < 0.05). No relevant IVI-related side effects were recorded. CONCLUSION: Compared to standard care, IVI was more effective in treating preoperative anemia in CRC patients and appeared to reduce infection rate, although it did not reduce postoperative RBCT.",

author = "Laso-Morales, \{Mar{\'i}a Jes{\'u}s\} and Carlos Jeric{\'o} and Susana G{\'o}mez-Ram{\'i}rez and Jordi Castellv{\'i} and Lorenzo Viso and Inmaculada Roig-Mart{\'i}nez and Caridad Pontes and Manuel Mu{\~n}oz",

year = "2017",

month = jan,

day = "1",

doi = "10.1111/trf.14278",

language = "English",

volume = "57",

pages = "3040--3048",

journal = "Transfusion",

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TY - JOUR

T1 - Preoperative management of colorectal cancer–induced iron deficiency anemia in clinical practice: data from a large observational cohort

AU - Laso-Morales, María Jesús

AU - Jericó, Carlos

AU - Gómez-Ramírez, Susana

AU - Castellví, Jordi

AU - Viso, Lorenzo

AU - Roig-Martínez, Inmaculada

AU - Pontes, Caridad

AU - Muñoz, Manuel

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Preoperative anemia prevalence among colorectal cancer (CRC) patients is high and may adversely influence postoperative outcome. This study assesses the efficacy of a preoperative anemia managing protocol in CRC. STUDY DESIGN AND METHODS: This was a retrospective analysis of consecutive CRC resections at two Spanish centers (January 2012 to December 2013). Preoperative anemia was defined as a hemoglobin (Hb) level of less than 13 g/dL and treated with intravenous iron (IVI) or standard care (oral iron or no iron). Red blood cell transfusion (RBCT) requirements was the primary outcome variable. Postoperative infection rate and length of hospital stay (LOS) were secondary outcome variables. Patients were managed with a restrictive transfusion trigger (Hb < 8 g/dL). Infection was diagnosed clinically and confirmed by laboratory, microbiologic, and/or radiologic evidence. RESULTS: Overall, 322 of 571 patients (56%) presented with anemia: 232 received IVI and 90 standard care. There were differences in RBCT rate between no anemia and anemia (2% vs. 16%; p < 0.01), but not in postoperative infections (19% vs. 22%; p = NS) or LOS. Compared to those on standard care, anemic patients on IVI presented with lower Hb (10.8 g/dL vs. 12.0 g/dL; p < 0.001) at baseline, but similar Hb on day of surgery and Postoperative Day 30. There were no between-group differences in RBCT rates (16% vs. 17%; p = NS), but infection rates were lower among IVI-treated patients (18% vs. 29%; p < 0.05). No relevant IVI-related side effects were recorded. CONCLUSION: Compared to standard care, IVI was more effective in treating preoperative anemia in CRC patients and appeared to reduce infection rate, although it did not reduce postoperative RBCT.

AB - Preoperative anemia prevalence among colorectal cancer (CRC) patients is high and may adversely influence postoperative outcome. This study assesses the efficacy of a preoperative anemia managing protocol in CRC. STUDY DESIGN AND METHODS: This was a retrospective analysis of consecutive CRC resections at two Spanish centers (January 2012 to December 2013). Preoperative anemia was defined as a hemoglobin (Hb) level of less than 13 g/dL and treated with intravenous iron (IVI) or standard care (oral iron or no iron). Red blood cell transfusion (RBCT) requirements was the primary outcome variable. Postoperative infection rate and length of hospital stay (LOS) were secondary outcome variables. Patients were managed with a restrictive transfusion trigger (Hb < 8 g/dL). Infection was diagnosed clinically and confirmed by laboratory, microbiologic, and/or radiologic evidence. RESULTS: Overall, 322 of 571 patients (56%) presented with anemia: 232 received IVI and 90 standard care. There were differences in RBCT rate between no anemia and anemia (2% vs. 16%; p < 0.01), but not in postoperative infections (19% vs. 22%; p = NS) or LOS. Compared to those on standard care, anemic patients on IVI presented with lower Hb (10.8 g/dL vs. 12.0 g/dL; p < 0.001) at baseline, but similar Hb on day of surgery and Postoperative Day 30. There were no between-group differences in RBCT rates (16% vs. 17%; p = NS), but infection rates were lower among IVI-treated patients (18% vs. 29%; p < 0.05). No relevant IVI-related side effects were recorded. CONCLUSION: Compared to standard care, IVI was more effective in treating preoperative anemia in CRC patients and appeared to reduce infection rate, although it did not reduce postoperative RBCT.

UR - https://www.scopus.com/pages/publications/85027692728

U2 - 10.1111/trf.14278

DO - 10.1111/trf.14278

M3 - Article

SN - 0041-1132

VL - 57

SP - 3040

EP - 3048

JO - Transfusion

JF - Transfusion

IS - 12

ER -

Preoperative management of colorectal cancer–induced iron deficiency anemia in clinical practice: data from a large observational cohort

Resumen

ODS de las Naciones Unidas

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Huella

Tesis doctorales

Ferroterapia endovenosa en la optimización de la hemoglobina en el postoperatorio de cirurgía neoplásica colorrectal: : influencia de las pautas posológicas en la tolerabilidad, el cumplimiento terapéutico y la efectividad del tratamiento.

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