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. 2025 Jan 7:11:1466924.
doi: 10.3389/fsurg.2024.1466924. eCollection 2024.

Preoperative anemia is associated with prolonged hospital stay and increased facility discharges after glioblastoma resection

Ahmad K Almekkawi  1 , Ammar Adenwalla #  2 , James P Caruso  2 , William H Hicks  2 , Benjamin Rail  2 , Carlos A Bagley  1 , Jonathan D Breshears  1 , Tarek Y El Ahmadieh  3 , Tomas Garzon-Muvdi  4 , Samuel A Goldlust  5
Affiliations

Preoperative anemia is associated with prolonged hospital stay and increased facility discharges after glioblastoma resection

Ahmad K Almekkawi et al. Front Surg. .

Abstract

Background: Despite numerous operative and non-operative treatment modalities, patients with glioblastoma (GBM) have a dismal prognosis. Identifying predictors of survival and recurrence is an essential strategy for guiding treatment decisions, and existing literature demonstrates associations between hematologic data and clinical outcomes in cancer patients. As such, we provide a novel analysis that examines associations between preoperative hematologic data and postoperative outcomes following GBM resection.

Methods: We performed a retrospective analysis of patients who underwent GBM resection from January 2016 to December 2020. Standard demographic and clinical variables were collected, including pre-operative complete blood count (CBC), and inferential analyses were performed to analyze associations between CBC parameters and postoperative outcomes.

Results: One hundred and eighty nine (189) patients met inclusion criteria, with a mean age of 60.7 years. On multivariate regression analysis, controlling for age, gender, and performance status, we observed trends suggesting anemic patients may have longer lengths of stay (t statistic = 3.23, p = 0.0015) and higher rates of discharge to inpatient facilities [OR 3.01 (1.09-8.13), p = 0.029], though these associations did not reach statistical significance after correction for multiple comparisons (Bonferroni-corrected significance threshold p < 0.01).

Conclusion: Preoperative anemia may be a useful pre-operative predictor of postsurgical GBM outcomes. Further study is required to determine whether pre-operative hemoglobin optimization can improve postoperative clinical outcomes, and whether other hematologic and inflammatory markers are predictive of postoperative recovery and functional status.

Keywords: absolute lymphocyte count; anemia; glioblastoma; neutrophil-lymphocyte ratio; postoperative outcomes anemia; resection.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Consort diagram.
Figure 2
Figure 2
Kaplan-Meier survival curves.
Figure 3
Figure 3
Decision tree visualization; gini: gini index, which is a measure of node impurity used in the decision tree analysis.
See this image and copyright information in PMC

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