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Abstract：
OBJECTIVE: Patients with spinal metastases undergoing surgical treatment face challenges related to preoperative anemia, intraoperative blood loss, and frailty, emphasizing the significance of perioperative blood management. This retrospective analysis aimed to assess the correlation between hemoglobin-related parameters and outcomes, identifying key markers to aid in blood management.
METHODS: A retrospective review was performed to identify patients who underwent surgical treatment for spinal metastases. Hb-related parameters, including baseline Hb, postoperative nadir Hb, predischarge Hb, postoperative nadir Hb drift, and predischarge Hb drift (both in absolute values and percentages) were subjected to univariate and multivariate analyses. These analyses were conducted in conjunction with other established variables to identify independent markers predicting patient outcomes. The outcomes of interest were postoperative short-term (6-week) mortality, long-term (1-year) mortality, and postoperative 30-day morbidity.
RESULTS: A total of 289 patients were included. Our study demonstrated that predischarge Hb (OR 0.62, 95% CI 0.44-0.88, P = 0.007) was an independent prognostic factor of short-term mortality, while baseline Hb (OR 0.76, 95% CI 0.66-0.88, P < 0.001) was identified as an independent prognostic factor of long-term mortality. Additionally, nadir Hb drift (OR 0.82, 95% CI 0.70-0.97, P = 0.023) was found to be an independent prognostic factor for postoperative 30-day morbidity.
CONCLUSIONS: This study demonstrated that predischarge Hb, baseline Hb, and nadir Hb drift are prognostic factors for outcomes. These findings provide a foundation for precise blood management strategies. It is crucial to consider Hb-related parameters appropriately, and prospective intervention studies addressing these markers should be conducted in the future.
METHODS: A retrospective review was performed to identify patients who underwent surgical treatment for spinal metastases. Hb-related parameters, including baseline Hb, postoperative nadir Hb, predischarge Hb, postoperative nadir Hb drift, and predischarge Hb drift (both in absolute values and percentages) were subjected to univariate and multivariate analyses. These analyses were conducted in conjunction with other established variables to identify independent markers predicting patient outcomes. The outcomes of interest were postoperative short-term (6-week) mortality, long-term (1-year) mortality, and postoperative 30-day morbidity.
RESULTS: A total of 289 patients were included. Our study demonstrated that predischarge Hb (OR 0.62, 95% CI 0.44-0.88, P = 0.007) was an independent prognostic factor of short-term mortality, while baseline Hb (OR 0.76, 95% CI 0.66-0.88, P < 0.001) was identified as an independent prognostic factor of long-term mortality. Additionally, nadir Hb drift (OR 0.82, 95% CI 0.70-0.97, P = 0.023) was found to be an independent prognostic factor for postoperative 30-day morbidity.
CONCLUSIONS: This study demonstrated that predischarge Hb, baseline Hb, and nadir Hb drift are prognostic factors for outcomes. These findings provide a foundation for precise blood management strategies. It is crucial to consider Hb-related parameters appropriately, and prospective intervention studies addressing these markers should be conducted in the future.
摘要：
目的：接受手术治疗的脊柱转移瘤患者面临与术前贫血相关的挑战，术中失血,和脆弱，强调围手术期血液管理的重要性。这项回顾性分析旨在评估血红蛋白相关参数与结局之间的相关性，确定关键标记以帮助血液管理。
方法：对脊柱转移瘤患者进行回顾性分析。Hb相关参数,包括基线Hb，术后最低点Hb,预放电Hb,术后最低点血红蛋白漂移,和出院前Hb漂移（绝对值和百分比）进行单变量和多变量分析。这些分析与其他已建立的变量一起进行,以鉴定预测患者结果的独立标志物。感兴趣的结果是术后短期（6周）死亡率，长期（1年）死亡率，和术后30天的发病率。
结果：共289例患者纳入研究。我们的研究表明，出院前Hb（OR0.62，95％CI0.44-0.88，P=0.007）是短期死亡率的独立预后因素。而基线Hb(OR0.76,95%CI0.66-0.88,P<0.001)被确定为长期死亡率的独立预后因素。此外,发现最低点Hb漂移（OR0.82，95％CI0.70-0.97，P=0.023）是术后30天发病率的独立预后因素。
结论：这项研究表明，基线Hb,和最低点血红蛋白漂移是预后因素。这些发现为精确的血液管理策略提供了基础。适当考虑Hb相关参数至关重要，未来应进行针对这些标志物的前瞻性干预研究。
方法：对脊柱转移瘤患者进行回顾性分析。Hb相关参数,包括基线Hb，术后最低点Hb,预放电Hb,术后最低点血红蛋白漂移,和出院前Hb漂移（绝对值和百分比）进行单变量和多变量分析。这些分析与其他已建立的变量一起进行,以鉴定预测患者结果的独立标志物。感兴趣的结果是术后短期（6周）死亡率，长期（1年）死亡率，和术后30天的发病率。
结果：共289例患者纳入研究。我们的研究表明，出院前Hb（OR0.62，95％CI0.44-0.88，P=0.007）是短期死亡率的独立预后因素。而基线Hb(OR0.76,95%CI0.66-0.88,P<0.001)被确定为长期死亡率的独立预后因素。此外,发现最低点Hb漂移（OR0.82，95％CI0.70-0.97，P=0.023）是术后30天发病率的独立预后因素。
结论：这项研究表明，基线Hb,和最低点血红蛋白漂移是预后因素。这些发现为精确的血液管理策略提供了基础。适当考虑Hb相关参数至关重要，未来应进行针对这些标志物的前瞻性干预研究。
