Impact and Outcomes of Postoperative Anaemia in Colorectal Cancer Patients: A Systematic Review

University of the West of England, Glenside Campus, Blackberry Hill, Stapleton, Bristol, BS16 1DD, UK. Department of General Surgery, Yeovil District Hospital, Higher Kingston, Yeovil, Somerset, BA21 4AT, UK. Medical Affair Department, Pharmacosmos UK Ltd, 33 King's Road, Reading, RG1 3AR, UK. Directorate of Training, Northwick Park Institute of Medical Research, Northwick Park Hospital, Harrow, HA1 3UJ. Division of Surgery and interventional science, University College London, UK.

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland. 2020
PICO Summary

Population

Colorectal cancer patients undergoing surgery (6 studies, n= 1,714).

Intervention

Systematic review to determine the prevalence and consequences of postoperative anaemia.

Comparison

Outcome

The prevalence of anaemia at discharge of 76.6% was reported as the primary endpoint in only one study. The rate of red blood cell transfusion and length of hospital stay were found to be significantly increased in anaemic patients, while postoperative infection rate results were variable. Quality of life scores and overall survival at 5 years were significantly affected among anaemic patients as reported in two papers.
Abstract
OBJECTIVES Preoperative anaemia is common in colorectal cancer patients. Little attention has been given to the prevalence and consequences of postoperative anaemia. The aim of this study was to systematically review the published literature and determine the knowledge of prevalence and impact of postoperative anaemia in colorectal cancer patients. METHODS Databases, CINAHL and Medline, via EBSCO Host, were systematically searched to identify suitable articles published between 2004-2020. After an initial search, articles were screened and all eligible articles reported on prevalence of postoperative anaemia, clinical and long-term outcomes data in colorectal cancer patients undergoing surgery were included. The Risk of Bias 2.0 tool for the assessment of Randomised Controlled Trials and Risk of Bias in Non-randomised studies 1.0 tool were used for the assessment of bias in the studies selected in our review. RESULTS Six studies, one randomised control trial and five cohort studies were included with a total population size of 1714. The prevalence of anaemia at discharge of 76.6% was reported as the primary endpoint in only one study. The rate of Red Blood Cell Transfusion and length of hospital stay were found to be significantly increased in anaemic patients, while postoperative infection rate results were variable. Quality of life scores and overall survival at 5 years were significantly affected among anaemic patients as reported in two papers. CONCLUSION The available limited evidence on postoperative anaemia indicates its high prevalence with negative impact on clinical and long-term outcomes. Further research is required to standardise the measurement and address the true impact of correcting postoperative anaemia on functional and oncological outcomes.
Study details
Study Design : Systematic Review
Language : eng
Additional Material : Letter in: ‘Colorectal Disease: the official journal of the Association of Coloproctology of Great Britain and Ireland’ (2021), PMID: 34028962, DOI: <a href="http://dx.doi.org/10.1111/codi.15752">http://dx.doi.org/10.1111/codi.15752</a> Letter in: ‘Colorectal Disease: the official journal of the Association of Coloproctology of Great Britain and Ireland’ (2021), PMID: 34028957, DOI: <a href="http://dx.doi.org/10.1111/codi.15753">http://dx.doi.org/10.1111/codi.15753</a>
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine