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  • Necrostatin-1 br Characteristics No br Intraoperative transf

    2020-08-14


    Characteristics No. (%)
    Intraoperative transfusion, No. (%) p
    Sex
    Male
    Female
    Age, years
    a
    CVD
    Yes
    No
    Diabetes
    Yes
    No
    Dementia
    Yes
    No
    CrClb
    Surgical site
    HPBe
    Othersf
    Tumor stageg
    Stage 4
    Delirium Risk Scoreh
    Polypharmacy
    Yes
    No
    DIM
    Yes
    No
    FIM
    Yes
    No
    Short-acting anticoagulant
    Yes
    No
    Long-acting anticoagulant
    Yes
    No
    Short-acting antiplatelet
    Yes
    No
    Long-acting antiplatelet
    Yes
    No
    Short-acting NSAID
    Yes
    No
    Please cite this article as: Jeong YM et al., Association between preoperative use of antithrombotic medications and intraoperative transfusion in older patients undergoing cancer surgery, Asian Journal of Surgery, https://doi.org/10.1016/j.asjsur.2019.06.005
    + MODEL
    Antithrombotics and intraoperative transfusion
    Table 2 (continued )
    Characteristics No. (%)
    Intraoperative transfusion, No. (%) p
    Long-acting NSAID
    Peripheral vasodilator
    Streptokinase/Streptodornase
    Herbal medicine
    Hormone-related agents
    Metformin
    BMI: body mass index, CVD: cardiovascular disease, CrCl: creatinine clearance, DIM: delirium-inducing medication, FIM: fall-inducingmedication.
    a CVD included hypertension, ischemic Necrostatin-1 disease (unstable angina, stable angina, myocardial infarction), dyslipidemia, heartfailure, atrial fibrillation, and cerebral infarction. b There were 20 missing data entries for weight and CrCl. c Upper gastrointestinal (GI): esophagus, stomach, and duodenum. d Lower GI: intestine, colon, rectum, cecum, and anus. e Hepato-pancreato-biliary (HPB) tumor: liver, pancreas, or gallbladder. f Others included 93 breast cancer, 15 gynecologic cancer, 5 genitourinary cancer, and 9 other cancer types. g There were 34 missing data entries for tumor stage. h There were 6 missing data entries for delirium risk score.
    transfusion. Factors having a p-value less than 0.05 from the univariate analysis, along with strong confounders of age and sex, were included in the multivariate analysis. Variables with a p-value less than 0.05 were entered by stepwise selection. They were removed if the p-value was greater than 0.1. Odds ratio (OR) and adjusted odds ratio (AOR) were calculated from the univariate and multivariate analyses, respectively. A p-value less than 0.05 was considered statistically significant. Attributable risk (%) was calculated as (1e1/AOR) 100. All statistical analyses were carried out using the Statistical Package for Social Sciences version 17.0 for Windows (SPSS Inc., Chicago, IL, USA).
    3. Results
    A total of 475 cancer patients who underwent preoperative CGA and cancer surgery were included in the analysis. Of 527 eligible patients who were scheduled for cancer surgery and who underwent CGA from January 2014 to June 2015, 54 patients were excluded due to refusal of surgery (n Z 35), changed treatment plan (n Z 13), and age less than 65 years (n Z 4).
    The number (percentage) of patients who were taking antithrombotics was 166 (34.9%); 10 (2.1%) were taking anticoagulants, 138 (29.1%) were taking antiplatelet med-ications, and three (2.2%) patients took both. As shown in Tables 2 and 3, patients taking long-acting anticoagulants before surgery showed an almost seven-fold higher intra-operative transfusion rate than those not taking long-acting anticoagulants before surgery. In contrast, patients who were taking long-acting antiplatelet medications before surgery did not show a significant propensity for transfusion.
    Multivariate analysis showed that patients with BMI less than 18.5 kg/m2 and those who underwent HPB surgery had an approximately 5-fold higher intraoperative transfusion rate compared to those with BMI 18.5 kg/m2 and who underwent lower GI surgery, respectively (Table 3), with an attributable risk of approximately 80%. Long-acting anti-coagulant use was the most significant factor for trans-fusion, with an AOR of 15.9 and attributable risk of almost 93.7%. Streptokinase/streptodornase therapy before sur-gery showed a marginally significant association with
    Please cite Chromomeres article as: Jeong YM et al., Association between preoperative use of antithrombotic medications and intraoperative transfusion in older patients undergoing cancer surgery, Asian Journal of Surgery, https://doi.org/10.1016/j.asjsur.2019.06.005
    + MODEL
    Table 3 Univariate and multivariate regression analyses to identify predictors for intraoperative transfusion.