Development and validation of a nomogram to predict intraoperative blood transfusion for gastric cancer surgery

2021 ◽  
Author(s):  
Haoquan Huang ◽  
Minghui Cao
2021 ◽  
pp. 1-10
Author(s):  
Sachiko Kaida ◽  
Toru Miyake ◽  
Satoshi Murata ◽  
Tsuyoshi Yamaguchi ◽  
Takeshi Tatsuta ◽  
...  

Introduction: This study aimed to clarify the frequency and risk factors of intercurrent venous thromboembolism (VTE) in patients undergoing major curative gastric cancer surgery. Methods: This prospective, multicenter, observational study included patients with gastric cancer who underwent radical gastrectomy at 5 hospitals between June 2016 and May 2018. Patients who were preoperatively administered anticoagulants were excluded. Results: A total of 126 patients were eligible to participate. VTE occurred within 9 days postoperatively in 5 cases (4.0%; 2 symptomatic and 3 asymptomatic). Postoperative day (POD) 1 plasma D-dimer and soluble fibrin (SF) levels were significantly higher in the VTE group than in the non-VTE group. Receiver-operating characteristic curve (ROC) analysis indicated a statistically significant ability of POD 1 D-dimer and SF levels to predict postoperative VTE development after gastrectomy; this finding was reflected by an area under the curve (AUC) of 0.97 (95% CI 0.92–1.0) and 0.87 (95% CI 0.74–1.0), respectively. Cutoff values of D-dimer (24.6 µg/mL) and SF (64.1 µg/mL) were determined. Intraoperative blood transfusion (odds ratio [OR] 7.86), POD 1 D-dimer ≥24.6 µg/mL (OR 17.35), and POD 1 SF ≥64.1 µg/mL (OR 19.5) were independent predictive factors for postoperative VTE (p < 0.05). Conclusion: VTE occurred in 4.0% patients (1.6% symptomatic and 2.4% asymptomatic) after gastric cancer surgery; however, with an early diagnosis and anticoagulant therapy, no patients experienced progression. Careful observation of patients with a high risk for VTE, including intraoperative blood transfusion and high POD 1 D-dimer or SF levels, would contribute to the early detection of VTE.


2020 ◽  
Author(s):  
Haoquan Huang ◽  
Zhixiao Han ◽  
Xia Liang ◽  
Zhongqi Liu ◽  
Shi Cheng ◽  
...  

Abstract Background This study aimed to construct and validate a nomogram composed of preoperative variables to predict perioperative blood transfusion for gastric cancer surgery. Methods 600 gastric cancer patients undergoing gastrectomy between January 2010 and December 2015 were selected as primary cohort. 399 patients from January 2016 to June 2019 were collected as validation cohort. In the primary cohort, univariate and multivariate analyses were performed to identify independent risk factors for blood transfusion. Using Akaike information criterion, selected variables were incorporated to construct a nomogram. Validations of the nomogram were performed in the primary and validation cohort. Discrimination of the nomogram was assessed by the concordance index (C-index) and calibration of the nomogram was assessed by calibration curve and Hosmer–Lemeshow goodness-of-fit test. Results The following independent risk factors for transfusion were identified: Charlson comorbidity index score over 3 (odds ratio (OR) 2.15), tumor location (diffuse vs upper: OR 1.50), pTNM stage (III vs I: OR 3.17), type of gastrectomy (subtotal vs total gastrectomy: OR 0.58), extragastric organ resection (OR 2.03) and preoperative hemoglobin less than 80 g/l (vs over 120 g/l: OR 66.03). C-index was 0.863 and 0.901 in the primary and validation cohort, respectively, indicating good discrimination of the nomogram. Both calibration curves and Hosmer–Lemeshow goodness-of-fit tests (P-value 0.716 and 0.935) demonstrated high agreement between prediction and actual outcome. Conclusion A nomogram composed of preoperative variables to predict blood transfusion for gastric cancer surgery was developed and validated. This nomogram could be used to improve utilization of packed red blood cells.


2013 ◽  
Vol 11 ◽  
pp. S100-S103 ◽  
Author(s):  
Stefano Rausei ◽  
Laura Ruspi ◽  
Federica Galli ◽  
Fabio Tirotta ◽  
Davide Inversini ◽  
...  

2020 ◽  
Vol 4 (4) ◽  
pp. 360-368 ◽  
Author(s):  
Takeshi Kubota ◽  
Katsutoshi Shoda ◽  
Hirotaka Konishi ◽  
Kazuma Okamoto ◽  
Eigo Otsuji

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e033267
Author(s):  
Dengfeng Wang ◽  
Yang Yu ◽  
Pengxian Tao ◽  
Dan Wang ◽  
Yajing Chen ◽  
...  

IntroductionVenous thromboembolism (VTE) is a serious life-threatening complication in patients with gastric cancer. Abnormal coagulation function and tumour-related treatment may contribute to the occurrence of VTE. Many guidelines considered that surgical treatment would put patients with cancer at high risk of VTE, so positive prevention is needed. However, there are no studies that have systematically reviewed the postoperative risk and distribution of VTE in patients with gastric cancer. We thus conduct this systematic review to determine the risk of VTE in patients with gastric cancer undergoing surgery and provide some evidence for clinical decision-making.Methods and analysisStudies reporting the incidence of VTE after gastric cancer surgery will be included. Primary studies of randomised controlled trials, cohort studies, population-based surveys and cross-sectional studies are eligible for this review and only studies published in Chinese and English will be included. We will search the Medline, Embase, Web of Science, CBM, CNKI and Wanfang data from their inception to November 2019. Two reviewers will independently select studies and extract data. The quality of each included study will be assessed with tools corresponding to their study design. Meta-analysis will be used to pool the incidence data from included studies. Heterogeneity of the estimates across studies will be assessed, if necessary, a subgroup analysis will be performed to explore the source of heterogeneity. The Grades of Recommendation, Assessment, Development and Evaluation method is applied to assess the level of evidence obtained from this systematic review.Ethics and disseminationThis proposed systematic review and meta-analysis is based on published data, and thus ethical approval is not required. The results of this review will be sought for publication.PROSPERO registration numberCRD42019144562


2021 ◽  
pp. 1-8
Author(s):  
Johannes Asplund ◽  
Eivind Gottlieb-Vedi ◽  
Wilhelm Leijonmarck ◽  
Fredrik Mattsson ◽  
Jesper Lagergren

PLoS ONE ◽  
2017 ◽  
Vol 12 (10) ◽  
pp. e0183955 ◽  
Author(s):  
Claudia Fischer ◽  
Hester Lingsma ◽  
Niek Klazinga ◽  
Richard Hardwick ◽  
David Cromwell ◽  
...  

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