title: Impact of perioperative hemoglobin levels on postoperative outcomes in gastric cancer surgery.
abstract: BACKGROUND
  The aim of this study was to evaluate the association of postoperative blood transfusion and anemia with postoperative outcomes in gastric cancer surgery.
  
  
  METHODS
  We enrolled 588 patients who had undergone curative resection for gastric cancer. Input variables for risk assessment consisted of 3 categories: patient demographics, surgical and pathological factors, and anemia-related factors. Postoperative outcomes included 30-day morbidity and mortality. Univariate and multivariate analyses were performed to identify risk factors influencing postoperative complications.
  
  
  RESULTS
  The rate of total complications was 19.0%. Comorbidity, lowest hemoglobin (Hb) level from the operative day up to postoperative day 7 (LOW-Hb), the percentage of drop in Hb level on postoperative day 2 (POD2-Hb change), and postoperative transfusion were independent risk factors in the multivariate analysis, with LOW-Hb and postoperative transfusion found to be the most significant factors. When LOW-Hb was ≥9.0 g/dL, postoperative complications were higher in the transfused group than in the non-transfused group (60.0 vs. 14.2%, respectively, p = 0.024), but when LOW-Hb was <9.0 g/dL, postoperative complications were not different between the 2 groups (44.6 vs. 37.5%, p = 0.525).
  
  
  CONCLUSIONS
  The lowest postoperative Hb level and postoperative transfusion were the most significant risk factors for postoperative complications in gastric cancer surgery.
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Do-Hyun
authors.initials: DH
authors.lastname: Jung
authors.forename: Hyuk-Joon
authors.initials: HJ
authors.lastname: Lee
authors.forename: Dong-Seok
authors.initials: DS
authors.lastname: Han
authors.forename: Yun-Suhk
authors.initials: YS
authors.lastname: Suh
authors.forename: Seong-Ho
authors.initials: SH
authors.lastname: Kong
authors.forename: Kuhn-Uk
authors.initials: KU
authors.lastname: Lee
authors.forename: Han-Kwang
authors.initials: HK
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000150:complications; D001803:Blood Transfusion / Q000379:methods*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology; D011184:Postoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000601:surgery*
chemical_list: D006454:Hemoglobins