Clinical Outcome and Risk Factors of Red Blood Cell Transfusion in Patients Undergoing Elective Primary Meningioma Resection
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patient Data
2.2. Anaemia Classification
2.3. Endpoints
2.4. Statistical Analysis
3. Results
3.1. Patient Cohort
3.2. Patient and Meningioma Characteristics Between the RBC Transfusion and Non-RBC Transfusion Group
3.3. Hb Values, Transfusion Rates and Postoperative Complications Between the RBC Transfusion and Non-RBC Transfusion Group
3.4. Risk Factors for RBC Transfusions
3.5. Survival
4. Discussion
4.1. Preoperative Anaemia and Clinical Outcome of RBC Transfusion
4.2. Risk Factors of RBC Transfusion
4.3. Strategies and Alternatives to RBC Transfusion
4.4. Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristic | RBC-Transfusion n (%) 68 (16.1%) | Non-RBC Transfusion n (%) 355 (83.9%) | p-Value |
---|---|---|---|
Male/Female | 25 (36.8%)/43 (63.2%) | 112 (31.5%)/243 (68.5%) | =0.4039 |
Age (years) * | 63 (51–71) | 56 (47–66) | =0.0153 |
Elderly (≥75 years) | 9 (13.2%) | 16 (4.5%) | =0.0068 |
BMI (kg/m2) * | 26.3 (22.8–38.9) | 26.3 (23.1–33.5) | =0.9825 |
ASA score ** | 1 (1.8%)/24 (42.1%)/30 (52.6%)/2 (3.5%) | 45 (15.0%)/181 (60.3%)/73 (24.3%)/1 (0.3%) | <0.0001 |
Comorbidities | |||
Smoking | 14 (20.6%) | 69 (19.4%) | =0.8264 |
Cardiovascular disease | 35 (51.5%) | 124 (34.9%) | =0.0107 |
Pulmonary disease | 8 (11.8%) | 23 (6.6%) | =0.1583 |
Diabetes | 13 (19.1%) | 32 (9.1%) | =0.0210 |
Endocrine disorders | 28 (41.2%) | 105 (29.6%) | =0.0676 |
Chronic kidney injury | 21 (30.9%) | 94 (26.6%) | =0.4273 |
Coagulopathy | 2 (2.9%) | 2 (0.6%) | =0.1167 |
Preoperative seizure ** | 16 (25%) | 80 (23.5%) | =0.8008 |
Meningioma | |||
Non-Skull-Base/Skull-Base | 40 (58.8%)/28 (41.2%) | 231 (65.1%)/124 (34.9%) | =0.3290 |
Tumor size (cm3) * | 64.9 (34.5–84.5) | 19.2 (7.6–40.4) | <0.0001 |
Near large vessel | 28 (40.2%) | 107 (30.1%) | =0.0787 |
Brain invasion ** | 16 (26.2%) | 63 (21.1%) | =0.3900 |
WHO grade I vs. II/III | 35 (51.5%)/33 (48.5%) | 227 (63.9%)/128 (36.4%) | =0.0615 |
Simpson grade <III/≥III ** | 18 (58%)/13 (41.9%) | 81 (73.6%)/29 (26.4%) | =0.1013 |
Ki67 (%) * | 3 (3–5) | 3 (3–5) | =0.3223 |
Mitosis <4/10HPF/4–20/10HPF/ >20/10HPF ** | 39 (69.6%)/24 (42.9%)/3 (5.4%) | 268 (78.4%)/70 (20.5%)/4 (1.2%) | =0.0040 |
Preoperative edema Non/≤tumor volume/ >tumor volume ** | 14 (21.5%)/29 (44.6%)/22 (33.8%) | 136 (41.3%)/107 (32.5%)/86 (26.1%) | =0.0079 |
Preoperative KPS ≤ 60% | 10 (14.7%) | 10 (2.8%) | =0.0003 |
Surgical Management | |||
Embolization | 1 (1.5%) | 0 (0%) | =0.0555 |
Surgical time (min) * | 320 (259.2–377) | 217 (169–290) | <0.0001 |
Intraoperative blood loss (mL) * | 1125 (525–1675) | 450 (300–1100) | <0.0001 |
Postoperative Complications | |||
Acute renal failure | 2 (2.9%) | 0 (0%) | =0.0067 |
Pneumonia | 13 (19.1%) | 5 (1.4%) | <0.0001 |
Sepsis | 2 (2.9%) | 0 (0%) | =0.0067 |
Pulmonary embolism | 10 (14.7%) | 16 (4.5%) | =0.0043 |
Seizure ** | 21 (36.8%) | 50 (15.2%) | =0.0003 |
Re-craniotomy ** | 22 (41.5%) | 36 (11.4%) | <0.0001 |
Hospital LOS (days) * | 15.5 (10.3–23) | 8 (7–11) | <0.0001 |
ICU LOS (days) * | 6 (2–15) | 1 (1–1) | <0.0001 |
Hb values and Transfusion rates | |||
Hb value (admission) (g/dL) * | 13.8 (12.8–14.7) | 14.1 (13.3–14.8) | =0.1072 |
Anaemia rate at admission | 12 (17.7%) | 22 (6.2%) | =0.0015 |
Hb value (discharge) (g/dL) * | 9.8 (8.7–10.5) | 11 (10–12) | <0.0001 |
Anaemia rate at discharge | 66 (97.0%) | 290 (81.6%) | =0.0002 |
Platelet transfusion rate | 7 (10.3%) | 2 (0.6%) | <0.0001 |
FFP transfusion rate | 10 (14.7%) | 1 (0.3%) | <0.0001 |
Fibrinogen transfusion rate | 19 (27.9%) | 5 (1.4%) | <0.0001 |
PCC transfusion rate | 10 (14.7%) | 9 (2.5%) | =0.0002 |
Risk Factor | Univariate Analysis | Multivariate Analysis | |||
---|---|---|---|---|---|
p-Value | p-Value | OR | RR | 95%CI | |
Anaemia at admission | =0.0015 | =0.0900 | 1.02 | 2.77 | −0.12–1.46 |
Age | =0.0153 | =0.5567 | 0.36 | 0.67 | −0.07–0.03 |
Elderly (≥75 years) | =0.0068 | =0.0905 | 0.46 | 0.90 | −0.47–1.31 |
ASA score | <0.0001 | =0.0247 | 1.48 | 8.74 | |
ASA score 2–1 | −4.84–0.62 | ||||
ASA score 3–2 | −2.02–0.08 | ||||
Cardiovascular disease | =0.0107 | =0.0700 | 1.21 | 3.47 | −0.03–1.07 |
Diabetes | =0.0210 | =0.4369 | 0.47 | 0.92 | −1.01–0.31 |
Preoperative KPS ≤ 60% | =0.0003 | =0.2309 | 0.52 | 1.08 | −0.39–1.24 |
Preoperative edema | =0.0079 | =0.7438 | 0.16 | 0.76 | |
≤tumor volume-Non | −1.41–1.02 | ||||
>tumor volume ≤tumor volume | −0.66–1.78 | ||||
Tumor size Mitosis | <0.001 =0.0040 | =0.0006 =0.3686 | 3.03 0.24 | 10.10 1.10 | −0.04–0.01 |
>4–20/10HPF <4/10HPF | −1.56–0.73 | ||||
>20/10HPF 4–20/10HPF | −3.64–2.67 | ||||
Surgical time | <0.0001 | =0.0018 | 2.11 | 7.10 | −0.01–0.00 |
Intraoperative blood loss | <0.0001 | <0.0001 | 4.38 | 16.80 | −0.01–0.00 |
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Neef, V.; König, S.; Monden, D.; Dubinski, D.; Benesch, A.; Raimann, F.J.; Piekarski, F.; Ronellenfitsch, M.W.; Harter, P.N.; Senft, C.; et al. Clinical Outcome and Risk Factors of Red Blood Cell Transfusion in Patients Undergoing Elective Primary Meningioma Resection. Cancers 2021, 13, 3601. https://doi.org/10.3390/cancers13143601
Neef V, König S, Monden D, Dubinski D, Benesch A, Raimann FJ, Piekarski F, Ronellenfitsch MW, Harter PN, Senft C, et al. Clinical Outcome and Risk Factors of Red Blood Cell Transfusion in Patients Undergoing Elective Primary Meningioma Resection. Cancers. 2021; 13(14):3601. https://doi.org/10.3390/cancers13143601
Chicago/Turabian StyleNeef, Vanessa, Sven König, Daniel Monden, Daniel Dubinski, Anika Benesch, Florian J. Raimann, Florian Piekarski, Michael W. Ronellenfitsch, Patrick N. Harter, Christian Senft, and et al. 2021. "Clinical Outcome and Risk Factors of Red Blood Cell Transfusion in Patients Undergoing Elective Primary Meningioma Resection" Cancers 13, no. 14: 3601. https://doi.org/10.3390/cancers13143601