Preoperative anemia is associated with increased use of hospital resources in patients undergoing elective hepatectomy

May C. Tee, Christopher R. Shubert, Daniel S. Ubl, Elizabeth B Habermann, David M. Nagorney, Florencia Que

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background In patients undergoing elective hepatectomy, we aimed to evaluate the effect of preoperative anemia on postoperative mortality, morbidity, readmission, risk of blood transfusion, and duration of hospital stay. Methods A total of 4,170 patients who underwent elective hepatectomy from 2010 to 2012 were identified in the American College of Surgeons National Surgical Quality Improvement Program. Univariate and multivariate analyses were performed by examination of the association of preoperative anemia (defined as hematocrit <5) and the risk of any perioperative blood transfusion (defined as ≥1 unit of blood within 72 hours of operation), mean duration of stay, prolonged duration of stay (defined as ≥9 days, which represented the 75th percentile of this cohort), 30-day readmission, major morbidity, and mortality. Results A total of 948 patients had preoperative anemia (22.7%). Preoperative anemia was associated with increased risk of any perioperative blood transfusion, prolonged duration of stay, major postoperative complication, and 30-day mortality (P <.05 for all analyses). After controlling for potentially confounding covariates, there was nearly a 3-fold greater risk of blood transfusion (adjusted OR = 2.79, P <.001) and 2-fold greater risk of prolonged duration of stay in anemic versus nonanemic patients (adjusted OR = 1.66, P <.001). Mean duration of stay was 10.0 days and 7.4 days for anemic and nonanemic patients, respectively (P <.001). Conclusion Anemia is associated with an almost 3-fold increased risk of blood transfusion, 2-fold increased risk of prolonged duration of hospitalization, and hospital stays were 2.6 days greater in anemic patients. Anemia may significantly impact resource utilization for elective hepatectomy.

Original languageEnglish (US)
Pages (from-to)1027-1038
Number of pages12
JournalSurgery (United States)
Volume158
Issue number4
DOIs
StatePublished - Oct 1 2015

Fingerprint

Hepatectomy
Anemia
Blood Transfusion
Mortality
Length of Stay
Morbidity
Quality Improvement
Hematocrit
Hospitalization
Multivariate Analysis

ASJC Scopus subject areas

  • Surgery

Cite this

Preoperative anemia is associated with increased use of hospital resources in patients undergoing elective hepatectomy. / Tee, May C.; Shubert, Christopher R.; Ubl, Daniel S.; Habermann, Elizabeth B; Nagorney, David M.; Que, Florencia.

In: Surgery (United States), Vol. 158, No. 4, 01.10.2015, p. 1027-1038.

Research output: Contribution to journalArticle

Tee, May C. ; Shubert, Christopher R. ; Ubl, Daniel S. ; Habermann, Elizabeth B ; Nagorney, David M. ; Que, Florencia. / Preoperative anemia is associated with increased use of hospital resources in patients undergoing elective hepatectomy. In: Surgery (United States). 2015 ; Vol. 158, No. 4. pp. 1027-1038.
@article{fd838ade66f14872b7f63d2efd6e25c8,
title = "Preoperative anemia is associated with increased use of hospital resources in patients undergoing elective hepatectomy",
abstract = "Background In patients undergoing elective hepatectomy, we aimed to evaluate the effect of preoperative anemia on postoperative mortality, morbidity, readmission, risk of blood transfusion, and duration of hospital stay. Methods A total of 4,170 patients who underwent elective hepatectomy from 2010 to 2012 were identified in the American College of Surgeons National Surgical Quality Improvement Program. Univariate and multivariate analyses were performed by examination of the association of preoperative anemia (defined as hematocrit <5) and the risk of any perioperative blood transfusion (defined as ≥1 unit of blood within 72 hours of operation), mean duration of stay, prolonged duration of stay (defined as ≥9 days, which represented the 75th percentile of this cohort), 30-day readmission, major morbidity, and mortality. Results A total of 948 patients had preoperative anemia (22.7{\%}). Preoperative anemia was associated with increased risk of any perioperative blood transfusion, prolonged duration of stay, major postoperative complication, and 30-day mortality (P <.05 for all analyses). After controlling for potentially confounding covariates, there was nearly a 3-fold greater risk of blood transfusion (adjusted OR = 2.79, P <.001) and 2-fold greater risk of prolonged duration of stay in anemic versus nonanemic patients (adjusted OR = 1.66, P <.001). Mean duration of stay was 10.0 days and 7.4 days for anemic and nonanemic patients, respectively (P <.001). Conclusion Anemia is associated with an almost 3-fold increased risk of blood transfusion, 2-fold increased risk of prolonged duration of hospitalization, and hospital stays were 2.6 days greater in anemic patients. Anemia may significantly impact resource utilization for elective hepatectomy.",
author = "Tee, {May C.} and Shubert, {Christopher R.} and Ubl, {Daniel S.} and Habermann, {Elizabeth B} and Nagorney, {David M.} and Florencia Que",
year = "2015",
month = "10",
day = "1",
doi = "10.1016/j.surg.2015.06.004",
language = "English (US)",
volume = "158",
pages = "1027--1038",
journal = "Surgery (United States)",
issn = "0039-6060",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Preoperative anemia is associated with increased use of hospital resources in patients undergoing elective hepatectomy

AU - Tee, May C.

AU - Shubert, Christopher R.

AU - Ubl, Daniel S.

AU - Habermann, Elizabeth B

AU - Nagorney, David M.

AU - Que, Florencia

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Background In patients undergoing elective hepatectomy, we aimed to evaluate the effect of preoperative anemia on postoperative mortality, morbidity, readmission, risk of blood transfusion, and duration of hospital stay. Methods A total of 4,170 patients who underwent elective hepatectomy from 2010 to 2012 were identified in the American College of Surgeons National Surgical Quality Improvement Program. Univariate and multivariate analyses were performed by examination of the association of preoperative anemia (defined as hematocrit <5) and the risk of any perioperative blood transfusion (defined as ≥1 unit of blood within 72 hours of operation), mean duration of stay, prolonged duration of stay (defined as ≥9 days, which represented the 75th percentile of this cohort), 30-day readmission, major morbidity, and mortality. Results A total of 948 patients had preoperative anemia (22.7%). Preoperative anemia was associated with increased risk of any perioperative blood transfusion, prolonged duration of stay, major postoperative complication, and 30-day mortality (P <.05 for all analyses). After controlling for potentially confounding covariates, there was nearly a 3-fold greater risk of blood transfusion (adjusted OR = 2.79, P <.001) and 2-fold greater risk of prolonged duration of stay in anemic versus nonanemic patients (adjusted OR = 1.66, P <.001). Mean duration of stay was 10.0 days and 7.4 days for anemic and nonanemic patients, respectively (P <.001). Conclusion Anemia is associated with an almost 3-fold increased risk of blood transfusion, 2-fold increased risk of prolonged duration of hospitalization, and hospital stays were 2.6 days greater in anemic patients. Anemia may significantly impact resource utilization for elective hepatectomy.

AB - Background In patients undergoing elective hepatectomy, we aimed to evaluate the effect of preoperative anemia on postoperative mortality, morbidity, readmission, risk of blood transfusion, and duration of hospital stay. Methods A total of 4,170 patients who underwent elective hepatectomy from 2010 to 2012 were identified in the American College of Surgeons National Surgical Quality Improvement Program. Univariate and multivariate analyses were performed by examination of the association of preoperative anemia (defined as hematocrit <5) and the risk of any perioperative blood transfusion (defined as ≥1 unit of blood within 72 hours of operation), mean duration of stay, prolonged duration of stay (defined as ≥9 days, which represented the 75th percentile of this cohort), 30-day readmission, major morbidity, and mortality. Results A total of 948 patients had preoperative anemia (22.7%). Preoperative anemia was associated with increased risk of any perioperative blood transfusion, prolonged duration of stay, major postoperative complication, and 30-day mortality (P <.05 for all analyses). After controlling for potentially confounding covariates, there was nearly a 3-fold greater risk of blood transfusion (adjusted OR = 2.79, P <.001) and 2-fold greater risk of prolonged duration of stay in anemic versus nonanemic patients (adjusted OR = 1.66, P <.001). Mean duration of stay was 10.0 days and 7.4 days for anemic and nonanemic patients, respectively (P <.001). Conclusion Anemia is associated with an almost 3-fold increased risk of blood transfusion, 2-fold increased risk of prolonged duration of hospitalization, and hospital stays were 2.6 days greater in anemic patients. Anemia may significantly impact resource utilization for elective hepatectomy.

UR - http://www.scopus.com/inward/record.url?scp=84940788567&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84940788567&partnerID=8YFLogxK

U2 - 10.1016/j.surg.2015.06.004

DO - 10.1016/j.surg.2015.06.004

M3 - Article

C2 - 26162941

AN - SCOPUS:84940788567

VL - 158

SP - 1027

EP - 1038

JO - Surgery (United States)

JF - Surgery (United States)

SN - 0039-6060

IS - 4

ER -