Original article

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Red blood cell transfusion in patients undergoing elective primary glioblastoma resection

Authors

Key words: red blood cells, anaemia, blood transfusion, glioblastoma
Publication Date: 2024-01-11

Abstract

Background - Red blood cell (RBC) transfusion in patients undergoing major elective cranial surgery is associated with increased postoperative morbidity and mortality. This study aims to identify the clinical outcome of transfused glioblastoma patients undergoing primary surgical tumor resection and identify risk factors for RBC transfusion.

Material and methods - Between 2009 and 2019, 406 patients underwent elective primary glioblastoma resection. For multivariate analysis to assess risk factors for RBC transfusion, logistic regression was conducted. The impact of RBC transfusion on overall survival was assessed using Kaplan-Meier analysis.

Results - In total, 36 (8.9%) patients received RBC transfusion. Preoperative anemia rate was significantly higher in transfused patients compared to patients without RBC transfusion (33.3 vs 6.5%; p<0.0001). Postoperative complications as well as hospital length of stay (LOS) (p<0.0001) were significantly increased in transfused patients compared to non-transfused patients. After multivariate analysis, risk factors for RBC transfusion were preoperative anemia (p<0.0001), intraoperative blood loss (p<0.0001), female gender (p=0.0056) and radiation (p=0.0064). Kaplan-Meier curves revealed that RBC transfusion and being elderly (age ≥75 years) were relevant for overall survival.

Discussion - RBC transfusion is associated with increased postoperative morbidity and mortality in patients undergoing elective primary glioblastoma resection. Preoperative anemia and intraoperative blood loss are major risk factors for RBC transfusion. Preoperative anemia management and blood conservation strategies are crucial in patients undergoing elective primary glioblastoma resection.

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Authors

Vanessa Neef - Goethe University Frankfurt, University Hospital, Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Frankfurt, Germany https://orcid.org/0000-0002-1793-2918

Sven König - Goethe University Frankfurt, Department of Neurosurgery, University Hospital Frankfurt, Frankfurt, Germany https://orcid.org/0000-0002-7904-1483

Becker Hendrik - Goethe University Frankfurt, University Hospital, Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Frankfurt, Germany https://orcid.org/0000-0003-4987-481X

Daniel Dubinski - Goethe University Frankfurt, Department of Neurosurgery, University Hospital Frankfurt, Frankfurt, Germany; Department of Neurosurgery, University Medicine Rostock, Rostock, Germany https://orcid.org/0000-0001-5568-8429

Armin Flinspach - Goethe University Frankfurt, University Hospital, Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Frankfurt, Germany https://orcid.org/0000-0003-2886-8947

Florian Juergen Raimann - Goethe University Frankfurt, University Hospital, Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Frankfurt, Germany https://orcid.org/0000-0002-6597-9585

Katharina Weber - Goethe University Frankfurt, Neurological Institute, Edinger Institute, Neuropathology, Frankfurt, Germany

Michael Ronellenfitsch - Goethe University Frankfurt, Neurological Institute, Edinger Institute, Neuropathology, Frankfurt, Germany https://orcid.org/0000-0002-1402-6290

Juergen Konczalla - Goethe University Frankfurt, Department of Neurosurgery, University Hospital Frankfurt, Frankfurt, Germany https://orcid.org/0000-0001-9771-7806

Elke Hattingen - Goethe University Frankfurt, Department of Neuroradiology, University Hospital Frankfurt, Frankfurt, Germany https://orcid.org/0000-0002-8392-9004

Marcus Czabanka - Goethe University Frankfurt, Department of Neurosurgery, University Hospital Frankfurt, Frankfurt, Germany https://orcid.org/0000-0001-8709-035X

Christian Senft - Friedrich Schiller University Jena, Department of Neurosurgery, University Hospital Jena, Jena, Germany https://orcid.org/0000-0003-1288-6913

Kai Zacharowski - Goethe University Frankfurt, University Hospital, Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Frankfurt, Germany https://orcid.org/0000-0002-0212-9110

Peter Baumgarten - Goethe University Frankfurt, Department of Neurosurgery, University Hospital Frankfurt, Frankfurt, Germany; Friedrich Schiller University Jena, Department of Neurosurgery, University Hospital Jena, Jena, Germany https://orcid.org/0000-0002-2563-2691

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