Citation: | LIU Wei, XU Xiaohan, YU Xuerong. Association Between Preoperative Hypoalbuminemia and Risk of Perioperative Allogeneic Red Blood Cell in Patients Undergoing Cytoreductive Surgery for Ovarian Cancer: A Single-center Retrospective Cohort Study[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(4): 839-844. DOI: 10.12290/xhyxzz.2023-0544 |
To analyze the correlation between preoperative hypoproteinemia and the risk of perioperative allogeneic erythrocyte transfusion in ovarian cancer patients undergoing cytoreductive surgery.
Ovarian cancer patients who underwent cytoreductive surgery at Peking Union Medical College Hospital from January 2014 to December 2018 were retrospectively included. Clinical data such as the patients' general information, preoperative plasma albumin, American Society of Anesthesiologists(ASA) classification, intraoperative bleeding volume, operation time, perioperative (intraoperative and within 3 d postoperatively)allogeneic red blood cell transfusion were collected, and the correlation between preoperative hypoproteinemia (plasma albumin < 35 g/L) and the risk of allogeneic red blood cell infusion was analyzed by using multivariate Logistic regression.
A total of 1001 ovarian cancer patients who met the inclusion and exclusion criteria were enrolled, of which 64 (6.4%) had preoperative hypoproteinemia and 481(48.1%) received perioperative allogeneic red blood cell transfusion. The rate of perioperative allogeneic red blood cell transfusion was higher in the patients with hypoproteinemia than in those without hypoproteinemia [84.4% (54/64) vs. 45.6% (427/937), P < 0.001]. Multivariate Logistic regression analysis corrected for confounders such as ASA classification, intraoperative bleeding volume, and operative time found that preoperative hypoproteinemia was significantly associated with the risk of perioperative allogeneic red blood cell transfusion (OR=5.68, 95% CI: 2.56-13.57, P < 0.001).
Preoperative hypoalbuminemia could be associated with the increased risk of perioperative transfusion in patients undergoing cytoreductive surgery for ovarian cancer.
[1] |
Prescott L S, Aloia T A, Brown A J, et al. Perioperative blood transfusion in gynecologic oncology surgery: analysis of the National Surgical Quality Improvement Program Database[J]. Gynecol Oncol, 2015, 136(1): 65-70. DOI: 10.1016/j.ygyno.2014.11.009
|
[2] |
Weber R S, Jabbour N, Martin R C G 2nd. Anemia and transfusions in patients undergoing surgery for cancer[J]. Ann Surg Oncol, 2008, 15(1): 34-45. DOI: 10.1245/s10434-007-9502-9
|
[3] |
Carson J L, Stanworth S J, Roubinian N, et al. Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion[J]. Cochrane Database Syst Rev, 2016, 10(10): CD002042.
|
[4] |
Bolton-Maggs P H B. SHOT conference report 2016: serious hazards of transfusion-human factors continue to cause most transfusion-related incidents[J]. Transfus Med, 2016, 26(6): 401-405. DOI: 10.1111/tme.12380
|
[5] |
Goldman M, Webert K E, Arnold D M, et al. Proceedings of a consensus conference: towards an understanding of TRALI[J]. Transfus Med Rev, 2005, 19(1): 2-31. DOI: 10.1016/j.tmrv.2004.10.001
|
[6] |
李鑫, 张国炜, 万江涛, 等. 术前低白蛋白血症与后路腰椎融合术后不良结局发生率的相关性[J]. 中国临床解剖学杂志, 2022, 40(4): 485-490. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLJZ202204021.htm
Li X, Zhang G W, Wan J T, et al. Correlation between preoperative hypoalbuminemia and prevalence of adverse events after posterior lumbar interbody fusion[J]. Chin J Clin Anat, 2022, 40(4): 485-490. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLJZ202204021.htm
|
[7] |
Phan K, Ranson W, White S J W, et al. Thirty-day perioperative complications, prolonged length of stay, and readmission following elective posterior lumbar fusion associated with poor nutritional status[J]. Global Spine J, 2019, 9(4): 417-423. DOI: 10.1177/2192568218797089
|
[8] |
Kim K, Seo H, Chin J H, et al. Preoperative hypoalbuminemia and anemia as predictors of transfusion in radical nephrectomy for renal cell carcinoma: a retrospective study[J]. BMC Anesthesiol, 2015, 15: 103. DOI: 10.1186/s12871-015-0089-6
|
[9] |
De la Garza Ramos R, Gelfand Y, Benton J A, et al. Rates, risk factors, and complications of red blood cell transfusion in metastatic spinal tumor surgery: an analysis of a prospective multicenter surgical database[J]. World Neurosurg, 2020, 139: e308-e315. DOI: 10.1016/j.wneu.2020.03.202
|
[10] |
Conrad L B, Awdeh H, Acosta-Torres S, et al. Pre-operative core muscle index in combination with hypoalbuminemia is associated with poor prognosis in advanced ovarian cancer[J]. J Surg Oncol, 2018, 117(5): 1020-1028. DOI: 10.1002/jso.24990
|
[11] |
Bohl D D, Shen M R, Kayupov E, et al. Hypoalbuminemia independently predicts surgical site infection, pneumonia, length of stay, and readmission after total joint arthroplasty[J]. J Arthroplasty, 2016, 31(1): 15-21. DOI: 10.1016/j.arth.2015.08.028
|
[12] |
胡俊, 袁瑞, 王琴. 术后低蛋白血症与补充人血白蛋白对卵巢癌手术切口愈合不良的影响[J]. 重庆医学, 2023, 52(15): 2320-2325. https://www.cnki.com.cn/Article/CJFDTOTAL-CQYX202315015.htm
Hu J, Yuan R, Wang Q. Effect of postoperative hypoproteinemia and supplement of human serum albumin on the development of poor wound healing following ovarian cancer surgery[J]. Chongqing Med J, 2023, 52(15): 2320-2325. https://www.cnki.com.cn/Article/CJFDTOTAL-CQYX202315015.htm
|
[13] |
陈月芬, 马玉燕. 低蛋白血症与子痫前期的发生和发展[J]. 中国计划生育和妇产科, 2021, 13(2): 10-12. https://www.cnki.com.cn/Article/CJFDTOTAL-JHFC202102003.htm
Chen Y F, Ma Y Y. Hypoproteinemia and the occurrence and development of preeclampsia[J]. Chin J Family Plann Gynecotokol, 2021, 13(2): 10-12. https://www.cnki.com.cn/Article/CJFDTOTAL-JHFC202102003.htm
|
[14] |
Newman J M, Sodhi N, Khlopas A, et al. Malnutrition increases the 30-day complication and re-operation rates in hip fracture patients treated with total hip arthroplasty[J]. Hip Int, 2020, 30(5): 635-640. DOI: 10.1177/1120700019862977
|
[15] |
Kamath A F, Ong K L, Lau E, et al. Quantifying the burden of revision total joint arthroplasty for periprosthetic infection[J]. J Arthroplasty, 2015, 30(9): 1492-1497. DOI: 10.1016/j.arth.2015.03.035
|
[16] |
戴仲, 李莉, 严静. 白蛋白用于液体复苏的研究进展[J]. 实用医学杂志, 2015, 31(20): 3442-3443. https://www.cnki.com.cn/Article/CJFDTOTAL-SYYZ201520054.htm
Dai Z, Li L, Yan J. Research progress on albumin for liquid resuscitation[J]. J Pract Med, 2015, 31(20): 3442-3443. https://www.cnki.com.cn/Article/CJFDTOTAL-SYYZ201520054.htm
|
[17] |
Vincent J L, Dubois M J, Navickis R J, et al. Hypoalbuminemia in acute illness: is there a rationale for interven-tion? A meta-analysis of cohort studies and controlled trials[J]. Ann Surg, 2003, 237(3): 319-334.
|
[18] |
赵滨如, 刘惠兰. 血浆蛋白测定对评价尿毒症病人营养不良的意义[J]. 北京医学, 2000, 22(3): 168. https://www.cnki.com.cn/Article/CJFDTOTAL-BJYX200003021.htm
Zhao B R, Liu H L. The significance of plasma protein measurement in evaluating malnutrition in patients with uremia[J]. Beijing Med J, 2000, 22(3): 168. https://www.cnki.com.cn/Article/CJFDTOTAL-BJYX200003021.htm
|
[19] |
张阳, 张立志, 李放, 等. 低蛋白血症与高龄患者腰椎融合术后并发症的相关性研究[J]. 中国骨与关节杂志, 2021, 10(4): 244-247. https://www.cnki.com.cn/Article/CJFDTOTAL-GZGL202104003.htm
Zhang Y, Zhang L Z, Li F, et al. Association between preoperative hypoalbuminemia and complications after posterior lumbar fusion in the elderly[J]. Chin J Bone Joint, 2021, 10(4): 244-247. https://www.cnki.com.cn/Article/CJFDTOTAL-GZGL202104003.htm
|
[20] |
王婷婷, 张锦. 腹部大手术围手术期低蛋白血症的原因及治疗进展[J]. 中国医师进修杂志, 2020, 43(6): 569-572.
Wang T T, Zhang J. The causes and treatment progress of perioperative hypoalbuminemia in major abdominal surgery[J]. Chin J Postgrad Med, 2020, 43(6): 569-572.
|
[21] |
王燕. 低蛋白血症与复发性脑梗死的相关性研究[J]. 中西医结合心脑血管病杂志, 2019, 17(2): 282-284. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYYY201902035.htm
Wang Y. A study on the correlation between hypoalbumine-mia and recurrent cerebral infarction[J]. Chin J Integr Med Cardio-Cerebrovasc Dis, 2019, 17(2): 282-284. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYYY201902035.htm
|
[22] |
Shah N R, Dumler F. Hypoalbuminaemia--a marker of cardiovascular disease in patients with chronic kidney disease stages Ⅱ-Ⅳ[J]. Int J Med Sci, 2008, 5(6): 366-370.
|
[23] |
Staples A O, Greenbaum L A, Smith J M, et al. Association between clinical risk factors and progression of chronic kidney disease in children[J]. Clin J Am Soc Nephrol, 2010, 5(12): 2172-2179. DOI: 10.2215/CJN.07851109
|
[24] |
Inker L A, Coresh J, Levey A S, et al. Estimated GFR, albuminuria, and complications of chronic kidney disease[J]. J Am Soc Nephrol, 2011, 22(12): 2322-2331. DOI: 10.1681/ASN.2010111181
|
[25] |
王元芬, 窦莎, 朱崇元, 等. 可吸收防粘连纤维膜对卵巢癌患者术后盆腔淋巴囊肿形成的影响[J]. 现代妇产科进展, 2022, 31(12): 906-910. https://www.cnki.com.cn/Article/CJFDTOTAL-XDFC202212006.htm
Wang Y F, Dou S, Zhu C Y, et al. Effect of absorbable anti-adhesion fibrous membrane on the incidence of lymphoceles in patients with ovarian cancer[J]. Prog Obstet Gynecol, 2022, 31(12): 906-910. https://www.cnki.com.cn/Article/CJFDTOTAL-XDFC202212006.htm
|
[26] |
Dickerson R N, White K G, Curcillo P G 2nd, et al. Resting energy expenditure of patients with gynecologic malignancies[J]. J Am Coll Nutr, 1995, 14(5): 448-454. DOI: 10.1080/07315724.1995.10718535
|
[27] |
Cham S, Chen L, St Clair C M, et al. Development and validation of a risk-calculator for adverse perioperative outcomes for women with ovarian cancer[J]. Am J Obstet Gynecol, 2019, 220(6): 571. e1-571. e8. DOI: 10.1016/j.ajog.2019.02.019
|
[28] |
Wu Y, Mu J, Cao J, et al. Research status and progress of nutritional support therapy for ovarian cancer[J]. Nutr Cancer, 2022, 74(5): 1519-1526. DOI: 10.1080/01635581.2021.1957132
|
[29] |
杜权, 张华云, 汤红英. 严重低蛋白血症卵巢癌根治术后诱发急性肺水肿1例[J]. 陆军军医大学学报, 2000, 22(1): 52. https://www.cnki.com.cn/Article/CJFDTOTAL-DSDX200001021.htm
Du Q, Zhang H Y, Tang H Y. A case of pulmonary edema induced by sever hypoproteinemia after the radical operation of oophoroma[J]. J Army Med Univ, 2000, 22(1): 52. https://www.cnki.com.cn/Article/CJFDTOTAL-DSDX200001021.htm
|
[1] | GAO Yicheng, YU Zijin, WANG Yaqi, FANG Rui, WANG Cheng, LI Yuanyuan, DENG Yingjie, BAI Xue, XIANG Wenyuan, FEI Yutong. Clinical Questions Construction in Clinical Practice Guidelines: Based on Case-guided Approach[J]. Medical Journal of Peking Union Medical College Hospital, 2025, 16(1): 198-203. DOI: 10.12290/xhyxzz.2024-0017 |
[2] | GAO Yicheng, LIU Zhihan, TAO Liyuan, CAO Rui, XIA Ruyu, FENG Yuting, FANG Rui, DENG Yingjie, XIANG Wenyuan, FEI Yutong. Considerations and Methodological Suggestions on Health Equity in Clinical Practice Guideline Development[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(6): 1319-1324. DOI: 10.12290/xhyxzz.2023-0096 |
[3] | WANG Ling, WANG Ping, SU Renfeng, ZHAO Junxian, ZHU Di, LI Zhewei, HE Hongfeng, LUO Xufei, LIU Hui, ZHANG Hairong, WANG Xiaohui, CHEN Yaolong. Analysis of Development Method of Clinical Practice Guidelines in Primary Care[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(6): 1310-1318. DOI: 10.12290/xhyxzz.2023-0455 |
[4] | SU Renfeng, YU Xuan, SHI Qianling, LUO Xufei, SUN Yajia, LAN Hui, REN Mengjuan, WU Shouyuan, WANG Ping, WANG Ling, ZHAO Junxian, CHEN Yaolong. Current Situation and Progress of Evidence Synthesis Methodology[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(6): 1301-1309. DOI: 10.12290/xhyxzz.2023-0062 |
[5] | LIANG Changhao, YIN Guanxiang, WANG Yaqi, LIU Siqi, GAO Yicheng, LIU Pengwei, SU Xiangfei, FEI Yutong. Application of Delphi Method in the Development and Revision of Clinical Practice Guidelines of Traditional Chinese Medicine: Process and Suggestions[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(5): 1084-1090. DOI: 10.12290/xhyxzz.2022-0649 |
[6] | ZHOU Qi, LI Qinyuan, LIU Yali, LUO Zhengxiu, ZHANG Weishe, CHEN Tong, LI Guobao, SHANG Hongcai, YANG Kehu, ZHANG Bo, CHEN Yaolong, ZHANG Shuyang. The Development of Guidelines for Rare Diseases: Past, Present and Future[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(3): 621-628. DOI: 10.12290/xhyxzz.2022-0360 |
[7] | LIU Yunlan, ZHANG Jingyi, SHI Qianling, YANG Nan, WANG Zijun, LUO Xufei, REN Mengjuan, XUN Yangqin, ZHOU Qi, LIU Hui, LYU Meng, CHEN Yaolong. Investigation and Evaluation of Chinese Clinical Practice Guidelines Published in Medical Journals in 2019:Methodological and Reporting Quality[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(2): 324-331. DOI: 10.12290/xhyxzz.2022-0027 |
[8] | Yao-long CHEN, Xian-zhuo ZHANG, Qi ZHOU, Xiao-xia PENG, Yan-ming XIE, Jing HU, Liang FU, Ke-hu YANG. Adaptation of Clinical Practice Guidelines[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(1): 102-108. DOI: 10.3969/j.issn.1674-9081.20200001 |
[9] | Yao-long CHEN, Yan-fang MA, Qi ZHOU, Ying-feng ZHOU, Lan-ting LYU, Suo-di ZHAI, Chen YAO, Hong-cai SHANG, Ke-hu YANG, You-ping LI. Who Should Participate in the Development of Clinical Practice Guidelines?[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(5): 524-530. DOI: 10.3969/j.issn.1674-9081.2019.05.017 |
[10] | Jing YUAN, Jun NI, Yi-cheng ZHU, Xiao-qing LIU, Ding-ding ZHANG, Hui PAN, Bin PENG, Li-ying CUI. Methods of Critical Reading in Clinical Teaching: Teaching Design and Practice[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(2): 189-192. DOI: 10.3969/j.issn.1674-9081.2019.02.020 |
1. |
胡荻,水一方,苗轲轲,李孟圈. 他汀类药物对乳腺癌保护作用的孟德尔随机化研究. 肿瘤防治研究. 2025(02): 165-171 .
![]() |