Association between preoperative hematocrit and postoperative 30-day mortality in adult patients with tumor craniotomy
BackgroundThe purpose of this research was to synthesize the American College of Surgeons National Surgical Quality Improvement Program database to investigate the link between preoperative hematocrit and postoperative 30-day mortality in patients with tumor craniotomy.MethodsA secondary retrospecti...
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1059401/full |
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| author | Yufei Liu Yufei Liu Yufei Liu Lunzou Li Haofei Hu Haofei Hu Jihu Yang Jihu Yang Xiejun Zhang Xiejun Zhang Lei Chen Lei Chen Fanfan Chen Fanfan Chen Shuyu Hao Weiping Li Weiping Li Guodong Huang Guodong Huang |
| author_facet | Yufei Liu Yufei Liu Yufei Liu Lunzou Li Haofei Hu Haofei Hu Jihu Yang Jihu Yang Xiejun Zhang Xiejun Zhang Lei Chen Lei Chen Fanfan Chen Fanfan Chen Shuyu Hao Weiping Li Weiping Li Guodong Huang Guodong Huang |
| author_sort | Yufei Liu |
| collection | DOAJ |
| description | BackgroundThe purpose of this research was to synthesize the American College of Surgeons National Surgical Quality Improvement Program database to investigate the link between preoperative hematocrit and postoperative 30-day mortality in patients with tumor craniotomy.MethodsA secondary retrospective analysis of electronic medical records of 18,642 patients with tumor craniotomy between 2012 and 2015 was performed. The principal exposure was preoperative hematocrit. The outcome measure was postoperative 30-day mortality. We used the binary logistic regression model to explore the link between them and conducted a generalized additive model and smooth curve fitting to investigate the link and its explicit curve shape. We conducted sensitivity analyses by converting a continuous HCT into a categorical variable and calculated an E-value.ResultsA total of 18,202 patients (47.37% male participants) were included in our analysis. The postoperative 30-day mortality was 2.5% (455/18,202). After adjusting for covariates, we found that preoperative hematocrit was positively associated with postoperative 30-day mortality (OR = 0.945, 95% CI: 0.928, 0.963). A non-linear relationship was also discovered between them, with an inflection point at a hematocrit of 41.6. The effect sizes (OR) on the left and right sides of the inflection point were 0.918 (0.897, 0.939) and 1.045 (0.993, 1.099), respectively. The sensitivity analysis proved that our findings were robust. The subgroup analysis demonstrated that a weaker association between preoperative hematocrit and postoperative 30-day mortality was found for patients who did not use steroids for chronic conditions (OR = 0.963, 95% CI: 0.941–0.986), and a stronger association was discovered in participants who used steroids (OR = 0.914, 95% CI: 0.883–0.946). In addition, there were 3,841 (21.1%) cases in the anemic group (anemia is defined as a hematocrit (HCT) <36% in female participants and <39% in male participants). In the fully adjusted model, compared with the non-anemic group, patients in the anemic group had a 57.6% increased risk of postoperative 30-day mortality (OR = 1.576; 95% CI: 1.266, 1.961).ConclusionThis study confirms that a positive and nonlinear association exists between preoperative hematocrit and postoperative 30-day mortality in adult patients undergoing tumor craniotomy. Preoperative hematocrit was significantly associated with postoperative 30-day mortality when the preoperative hematocrit was <41.6. |
| first_indexed | 2024-04-10T09:07:21Z |
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| last_indexed | 2024-04-10T09:07:21Z |
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| series | Frontiers in Neurology |
| spelling | doaj.art-16346880108d48f68d97f557fc0a827a2023-02-21T05:34:35ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-02-011410.3389/fneur.2023.10594011059401Association between preoperative hematocrit and postoperative 30-day mortality in adult patients with tumor craniotomyYufei Liu0Yufei Liu1Yufei Liu2Lunzou Li3Haofei Hu4Haofei Hu5Jihu Yang6Jihu Yang7Xiejun Zhang8Xiejun Zhang9Lei Chen10Lei Chen11Fanfan Chen12Fanfan Chen13Shuyu Hao14Weiping Li15Weiping Li16Guodong Huang17Guodong Huang18Shenzhen Key Laboratory of Neurosurgery, Department of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaShenzhen University Health Science Center, Shenzhen, Guangdong, ChinaDepartment of Neurosurgery, Hechi People's Hospital, Hechi, Guangxi, ChinaShenzhen University Health Science Center, Shenzhen, Guangdong, ChinaDepartment of Nephrology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, ChinaShenzhen Key Laboratory of Neurosurgery, Department of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, ChinaShenzhen University Health Science Center, Shenzhen, Guangdong, ChinaShenzhen Key Laboratory of Neurosurgery, Department of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, ChinaShenzhen University Health Science Center, Shenzhen, Guangdong, ChinaShenzhen Key Laboratory of Neurosurgery, Department of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, ChinaShenzhen University Health Science Center, Shenzhen, Guangdong, ChinaShenzhen Key Laboratory of Neurosurgery, Department of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, ChinaShenzhen University Health Science Center, Shenzhen, Guangdong, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaShenzhen Key Laboratory of Neurosurgery, Department of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, ChinaShenzhen University Health Science Center, Shenzhen, Guangdong, ChinaShenzhen Key Laboratory of Neurosurgery, Department of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, ChinaShenzhen University Health Science Center, Shenzhen, Guangdong, ChinaBackgroundThe purpose of this research was to synthesize the American College of Surgeons National Surgical Quality Improvement Program database to investigate the link between preoperative hematocrit and postoperative 30-day mortality in patients with tumor craniotomy.MethodsA secondary retrospective analysis of electronic medical records of 18,642 patients with tumor craniotomy between 2012 and 2015 was performed. The principal exposure was preoperative hematocrit. The outcome measure was postoperative 30-day mortality. We used the binary logistic regression model to explore the link between them and conducted a generalized additive model and smooth curve fitting to investigate the link and its explicit curve shape. We conducted sensitivity analyses by converting a continuous HCT into a categorical variable and calculated an E-value.ResultsA total of 18,202 patients (47.37% male participants) were included in our analysis. The postoperative 30-day mortality was 2.5% (455/18,202). After adjusting for covariates, we found that preoperative hematocrit was positively associated with postoperative 30-day mortality (OR = 0.945, 95% CI: 0.928, 0.963). A non-linear relationship was also discovered between them, with an inflection point at a hematocrit of 41.6. The effect sizes (OR) on the left and right sides of the inflection point were 0.918 (0.897, 0.939) and 1.045 (0.993, 1.099), respectively. The sensitivity analysis proved that our findings were robust. The subgroup analysis demonstrated that a weaker association between preoperative hematocrit and postoperative 30-day mortality was found for patients who did not use steroids for chronic conditions (OR = 0.963, 95% CI: 0.941–0.986), and a stronger association was discovered in participants who used steroids (OR = 0.914, 95% CI: 0.883–0.946). In addition, there were 3,841 (21.1%) cases in the anemic group (anemia is defined as a hematocrit (HCT) <36% in female participants and <39% in male participants). In the fully adjusted model, compared with the non-anemic group, patients in the anemic group had a 57.6% increased risk of postoperative 30-day mortality (OR = 1.576; 95% CI: 1.266, 1.961).ConclusionThis study confirms that a positive and nonlinear association exists between preoperative hematocrit and postoperative 30-day mortality in adult patients undergoing tumor craniotomy. Preoperative hematocrit was significantly associated with postoperative 30-day mortality when the preoperative hematocrit was <41.6.https://www.frontiersin.org/articles/10.3389/fneur.2023.1059401/fullhematocritbrain tumorcraniotomysteroidmortality |
| spellingShingle | Yufei Liu Yufei Liu Yufei Liu Lunzou Li Haofei Hu Haofei Hu Jihu Yang Jihu Yang Xiejun Zhang Xiejun Zhang Lei Chen Lei Chen Fanfan Chen Fanfan Chen Shuyu Hao Weiping Li Weiping Li Guodong Huang Guodong Huang Association between preoperative hematocrit and postoperative 30-day mortality in adult patients with tumor craniotomy Frontiers in Neurology hematocrit brain tumor craniotomy steroid mortality |
| title | Association between preoperative hematocrit and postoperative 30-day mortality in adult patients with tumor craniotomy |
| title_full | Association between preoperative hematocrit and postoperative 30-day mortality in adult patients with tumor craniotomy |
| title_fullStr | Association between preoperative hematocrit and postoperative 30-day mortality in adult patients with tumor craniotomy |
| title_full_unstemmed | Association between preoperative hematocrit and postoperative 30-day mortality in adult patients with tumor craniotomy |
| title_short | Association between preoperative hematocrit and postoperative 30-day mortality in adult patients with tumor craniotomy |
| title_sort | association between preoperative hematocrit and postoperative 30 day mortality in adult patients with tumor craniotomy |
| topic | hematocrit brain tumor craniotomy steroid mortality |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1059401/full |
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