Forskning ved Københavns Universitet - Københavns Universitet

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Preoperative anaemia and newly diagnosed cancer 1 year after elective total hip and knee arthroplasty

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • C C Jørgensen
  • Ø Jans
  • Kehlet, Henrik
  • Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement Collaborative Group
Background
Preoperative anaemia is a well-established risk factor for use of blood transfusions and postoperative morbidity. Consequently, focus on preoperative evaluation of haemoglobin levels is increasing. In this context, iron deficiency anaemia may be a symptom of undiscovered gastrointestinal (GI) cancer requiring further investigation. However, the association between preoperative anaemia and cancer 1 year after elective total hip (THA) and total knee arthroplasty (TKA) is unknown. We evaluated 1-year cancer diagnoses, particularly GI cancers, in anaemic and non-anaemic THA and TKA patients.

Study Design and Methods
A prospective database on preoperative patient characteristics from six Danish orthopaedic centres was cross-referenced with the Danish Cancer Registry for information on diagnoses of new cancers 1 year after surgery. Crude cancer risk estimates were calculated using chi-square and Fisher's exact test in the total study cohort. Adjusted risk estimates were obtained using propensity scores and the Mantel–Haenzel statistic.

Results
Of 5400 procedures, 731 (13·5%) were in anaemic patients. These were older and had more comorbidity than non-anaemic patients. There were 17 (2·3%) and 79 (1·6%) new cancers in anaemic and non-anaemic patients, respectively (OR: 1·38; 95% CI: 0·81–2·35, P = 0·228). After propensity matching of 661 anaemic and 1305 non-anaemic patients, we found no association between preoperative anaemia and cancer (OR: 0·94; 95% CI: 0·51–1·73, P = 0·837) or with GI cancers specifically (OR: 0·80; 95% CI: 0·25-2·56, P = 0·707).

Conclusion
Preoperative anaemia per se may not be related to being diagnosed with cancer 1 year after THA and TKA. The optimal criteria for preoperative referral of anaemic patients to gastroenterologist in elective THA and TKA need further investigation.
OriginalsprogEngelsk
TidsskriftVox Sanguinis
Vol/bind109
Udgave nummer1
Sider (fra-til)62-70
Antal sider9
ISSN0042-9007
DOI
StatusUdgivet - jul. 2015

ID: 160446947