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International Journal of Colorectal Disease

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Open Access 01-09-2020 | Colorectal Cancer | Original Article

Impact of anaemia at discharge following colorectal cancer surgery

Authors: Rebecca C. Dru, Nathan J. Curtis, Emma L. Court, Catherine Spencer, Sara El Falaha, Godwin Dennison, Richard Dalton, Andrew Allison, Jonathan Ockrim, Nader K. Francis

Published in: International Journal of Colorectal Disease | Issue 9/2020

Abstract

Objectives

Preoperative anaemia is common in patients with colorectal cancer and increasingly optimised prior to surgery. Comparably little attention is given to the prevalence and consequences of postoperative anaemia. We aimed to investigate the frequency and short- or long-term impact of anaemia at discharge following colorectal cancer resection.

Methods

A dedicated, prospectively populated database of elective laparoscopic colorectal cancer procedures undertaken with curative intent within a fully implemented ERAS protocol was utilised. The primary endpoint was anaemia at time of discharge (haemoglobin (Hb) < 120 g/L for women and < 135 g/L for men). Patient demographics, tumour characteristics, operative details and postoperative outcomes were captured. Median follow-up was 61 months with overall survival calculated with the Kaplan-Meier log rank method and Cox proportional hazard regression based on anaemia at time of hospital discharge.

Results

A total of 532 patients with median 61-month follow-up were included. 46.4% were anaemic preoperatively (cohort mean Hb 129.4 g/L ± 18.7). Median surgical blood loss was 100 mL (IQR 0–200 mL). Upon discharge, most patients were anaemic (76.6%, Hb 116.3 g/L ± 14, mean 19 g/L ± 11 below lower limit of normal, p < 0.001). 16.7% experienced postoperative complications which were associated with lower discharge Hb (112 g/L ± 12 vs. 117 g/L ± 14, p = 0.001). Patients discharged anaemic had longer hospital stays (7 [5–11] vs. 6 [5–8], p = 0.037). Anaemia at discharge was independently associated with reduced overall survival (82% vs. 70%, p = 0.018; HR 1.6 (95% CI 1.04–2.5), p = 0.034).

Conclusion

Anaemia at time of discharge following elective laparoscopic colorectal cancer surgery and ERAS care is common with associated negative impacts upon short-term clinical outcomes and long-term overall survival.

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Title: Impact of anaemia at discharge following colorectal cancer surgery
Authors: Rebecca C. Dru
Nathan J. Curtis
Emma L. Court
Catherine Spencer
Sara El Falaha
Godwin Dennison
Richard Dalton
Andrew Allison
Jonathan Ockrim
Nader K. Francis
Publication date: 01-09-2020
Publisher: Springer Berlin Heidelberg
Keywords: Colorectal Cancer
Colorectal Cancer
Published in: International Journal of Colorectal Disease / Issue 9/2020
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-020-03611-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Impact of anaemia at discharge following colorectal cancer surgery

Abstract

Objectives

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

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