Table 2.
Clinicopathological characteristics of patients undergoing elective, open surgery for colorectal cancer receiving any perioperative blood transfusion—propensity score matched cohort
| Characteristics | All [n = 116] | No transfusion [n = 58] | Transfusion [n = 58] | p value |
|---|---|---|---|---|
| Clinicopathological | ||||
| Age, years (< 65/65–74/≥ 75) | 35/39/42 | 16/22/20 | 19/17/22 | – |
| Sex (male/female) | 62/54 | 32/26 | 30/28 | – |
| BMI (< 20/20–25/26–30/> 30 kg/m2) | 10/35/40/31 | 5/20/17/16 | 5/15/23/15 | – |
| ASA (1/2/3/4) | 16/49/48/3 | 7/26/24/1 | 9/23/24/2 | – |
| Iron infusion (yes/no) | 8/108 | 8/50 | 0/58 | – |
| Approach (laparoscopic/open) | 44/72 | 25/33 | 19/39 | – |
| Operation duration, min [median (IQR)] | ||||
| Colonic | 164 (120–204) | 150 (120–193) | 171 (130–210) | – |
| Rectal | 292 (240–409) | 293 (240–360) | 292 (251–409) | – |
| Perioperative dexamethasone (yes/no) | 72/44 | 42/16 | 30/28 | – |
| Tumor site (colon/rectum) | 89/27 | 48/10 | 41/17 | – |
| TNM stage (0/I/II/III) | 4/15/52/45 | 1/8/26/23 | 3/7/26/22 | – |
| Neoadjuvant treatment (yes/no) | 19/95 | 9/48 | 10/47 | – |
| Hematological | ||||
| Preoperative Hb, g/L [median (IQR)] | 109 (101–118) | 110 (105–117) | 106 (98–128) | – |
| Preoperative anemia (no/microcytic/normocytic)a | 20/28/64/4 | 2/15/38/3 | 18/13/26/1 | – |
| POD 1 Hb, g/L [median (IQR)] | 95 (88–103) | 97 (91–104) | 93 (86–100) | 0.063 |
| POD 2 Hb, g/L [median (IQR)] | 93 (84–101) | 96 (90–101) | 89 (82–101) | 0.033 |
| POD 3 Hb, g/L [median (IQR)] | 96 (90–104) | 98 (89–105) | 95 (90–103) | 0.443 |
| POD 4 Hb, g/L [median (IQR)] | 97 (93–106) | 98 (94–107) | 96 (92–106) | 0.597 |
| POD 5 Hb, g/L [median (IQR) | 99 (93–107) | 99 (95–108) | 100 (92–107) | 0.820 |
| Systemic inflammation | ||||
| Preoperative mGPS (0/1/2)b | 8/82/26 | 43/4/11 | 39/4/15 | – |
| POD 1 CRP, mg/L [median(IQR)] | 87 (64–117) | 83 (55–112) | 96 (71–126) | 0.024 |
| POD 2 CRP, mg/L [median(IQR)] | 143 (86–198) | 122 (78–183) | 153 (117–201) | 0.011 |
| POD 3 CRP, mg/L [median (IQR)] | 126 (81–177) | 113 (66–173) | 130 (93–196) | 0.046 |
| POD 4 CRP, mg/L [median (IQR)] | 97 (59–174) | 93 (50–157) | 99 (63–239) | 0.029 |
| POD 5 CRP, mg/L [median (IQR)] | 81 (41–144) | 74 (42–118) | 96 (40–208) | 0.264 |
| POD 1 albumin, g/L [median (IQR)] | 26 (23–29) | 28 (25–31) | 24 (21–26) | < 0.001 |
| POD 2 albumin, g/L [median (IQR)] | 25 (23–29) | 28 (24–31) | 23 (21–26) | < 0.001 |
| POD 3 albumin, g/L [median(IQR)] | 25 (22–27) | 26 (24–30) | 24 (20–26) | < 0.001 |
| POD 4 albumin, g/L [median (IQR)] | 24 (22–27) | 26 (23–29) | 23 (21–26) | 0.025 |
| POD 5 albumin, g/L [median (IQR)] | 24 (22–28) | 27 (24–29) | 23 (19–25) | 0.003 |
| poGPS 3 (0/1/2)c | 66/21/22 | 35/13/7 | 31/8/15 | 0.031 |
| poGPS 4 (0/1//2)c | 69/8/20 | 32/6/7 | 37/2/13 | 0.344 |
| Short-term outcomes | ||||
| Any complication (yes/no) | 53/63 | 19/39 | 34/24 | 0.017 |
| Infective complication (yes/no) | 33/83 | 11/47 | 22/36 | 0.061 |
| Anastomotic leak (yes/no) | 10/106 | 1/57 | 9/49 | 0.021 |
| Clavien–Dindo grade (0–2/3–5) | 23/93 | 55/3 | 38/20 | < 0.001 |
| 30-day mortality (yes/no) | 1/115 | 0/58 | 1/57 | – |
| Length of stay, days [median (IQR)] | 8 (6–13) | 7 (5–12) | 11 (6–16) | 0.011 |
| Long-term outcomes | ||||
| Adjuvant treatment (yes/no) | 32/63 | 19/28 | 13/35 | 0.732 |
| 5-year CSS (%) | 78 | 90 | 70 | 0.199 |
| 5-year OS (%) | 72 | 85 | 63 | 0.094 |
Data are expressed as n unless otherwise specified
ASA American Society of Anesthesiologists grade, BMI body mass index, Hb hemoglobin, CRP C-reactive protein, OS overall survival, CSS cancer-specific survival, POD postoperative day, IQR interquartile range, mGPS modified Glasgow Prognostic Score, poGPS postoperative Glasgow Prognostic Score, MCV mean corpuscular volume
aMales = Hb < 130 g/L, females = < 120 g/L; microcytic = anemia and MCV < 80 fL; normocytic = anemia and MCV 80–100 fL
b0 = CRP < 10 mg/L; 1 = CRP ≥ 10 mg/L and albumin ≥ 35 g/L; 2 = CRP ≥ 10 mg/L and albumin < 35 g/L)
c0 = CRP < 150 mg/L; 1 = CRP ≥ 150 mg/L and albumin ≥ 25 g/L; 2 = CRP ≥ 150 mg/L and albumin < 25 g/L