No abstract

Preoperative anemia is progressively being recognized as a risk factor for poor perioperative outcomes including increased length of hospital stay and increased blood transfusions. The growth in prevalence of preoperative anemia in patients undergoing gynecological oncology procedures warrants greater attention to early identification for optimal surgical outcomes. This was a quantitative retrospective observational study consisting of 284 patients undergoing gynecological oncology procedures. The study sought to determine the frequency of anemia, iron deficiency and the effect of anemia on the number of blood transfusions from January 1 to December 31, 2014. Patients with anemia had significantly higher transfusion rates (44% versus 11%, p < 0.0001), considerably higher number of units transfused per patient (mean 1.19 units versus 0.28 units, p < 0.0001) and longer length of stays post-operatively (mean 5.9 days versus 4.6 days, p=0.0008). It was concluded that early identification and treatment of anemia is a key opportunity to optimized surgical outcomes.

As the number of cancer cases rise each year in Canada, so does the number of surgical oncology cases. Surgery presents a unique and heightened stressor for the body already experiencing volatility from factors such as disease and treatments. Perioperative red blood cell (RBC) transfusions are critical to stabilize hemoglobin levels and correct anemia, as well as provide a buffer against anticipated intraoperative blood loss. Thoroughly examining and anticipating risk factors related to the potential need for perioperative blood transfusions is necessary to improve outcomes. Research evidence in recent years related to perioperative blood management of oncology patients has specifically recommended active, coordinated programs to reduce the need and amount of blood transfusions administered pre-, intra-, and post-surgery. Coordination between surgical oncologists and a local or provincial patient blood management (PBM) program is an important strategy that allows patients at risk of perioperative complications to be identified and receive early interventions and ongoing observation.

Au Canada, le nombre de cas de cancer augmente chaque année et, par conséquent, le nombre de patients en oncologie qui subissent une opération. La chirurgie cause un stress particulièrement intense à l’organisme déjà fragilisé par la maladie et les traitements. Les transfusions périopératoires de globules rouges sont essentielles pour stabiliser le taux d’hémoglobine et soigner l’anémie, ainsi que pour gérer la perte de sang attendue pendant l’opération. Il est nécessaire d’examiner en profondeur et d’anticiper les facteurs de risque associés aux transfusions sanguines périopératoires pour améliorer le devenir des patients. Ces dernières années, la recherche sur la gestion périopératoire du sang des patients en oncologie recommande tout spécialement la création de programmes d’intervention coordonnés pour réduire la nécessité et le nombre de transfusions sanguines administrées avant, pendant et après l’opération. Pour recenser les patients à risque de complications périopératoires et leur faire bénéficier d’interventions rapides et d’une observation continue, la bonne stratégie est de mettre en lien les chirurgiens oncologues avec un programme local ou provincial de conservation du sang.