# Preoperative anaemia in distal pancreatectomy: a propensity-score matched analysis

## TL;DR

This study shows that preoperative anemia significantly increases the risk of complications after distal pancreatectomy surgery.

## Contribution

The study identifies preoperative anemia as an independent risk factor for major postoperative complications using a propensity-score matched analysis.

## Key findings

- Anaemic patients had significantly more postoperative major complications (54.1% vs. 23.8%).
- Preoperative anaemia was confirmed as a strong independent risk factor for postoperative major morbidity (OR 4.047).
- Anaemic patients had higher in-hospital mortality rates (14.1% vs. 2.4%).

## Abstract

Preoperative anaemia is a prevalent morbidity predictor that adversely affects short- and long-term outcomes of patients undergoing surgery. This analysis aimed to investigate preoperative anaemia and its detrimental effects on patients after distal pancreatectomy.

The present study was a propensity-score match analysis of 286 consecutive patients undergoing distal pancreatectomy. Patients were screened for preoperative anaemia and classified according to WHO recommendations. The primary outcome measure was overall morbidity. The secondary endpoints were in-hospital mortality and rehospitalization.

The preoperative anaemia rate before matching was 34.3% (98 patients), and after matching a total of 127 patients (non-anaemic 42 vs. anaemic 85) were included. Anaemic patients had significantly more postoperative major complications (54.1% vs. 23.8%; p < 0.01), a higher comprehensive complication index (26.2 vs. 4.3; p < 0.01), and higher in-hospital mortality rate (14.1% vs. 2.4%; p = 0.04).

Multivariate regression analysis confirmed these findings and identified preoperative anaemia as a strong independent risk factor for postoperative major morbidity (OR 4.047; 95% CI: 1.587–10.320; p < 0.01).

The current propensity-score matched analysis strongly considered preoperative anaemia as a risk factor for major complications following distal pancreatectomy. Therefore, an intense preoperative anaemia workup should be increasingly prioritised.