University of Twente Student Theses


Anemia is a preoperative risk factor for developing complications, predicting the need of prehabilitation in colorectal cancer patients.

Vollenbroek, C.L.T. (2022) Anemia is a preoperative risk factor for developing complications, predicting the need of prehabilitation in colorectal cancer patients.

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Embargo date:7 July 2027
Abstract:Colorectal cancer is a common type of cancer and the third most diagnosed type of cancer worldwide. Surgery is a common treatment where complication occur in about 30% of the patients. This cohort study examines colorectal cancer patients who underwent an elective surgery using Enhanced Recovery After Surgery (ERAS) protocols within Medisch Spectrum Twente (MST). The purpose is to understand what patients can be prepared for surgery to prevent complications and avoid a bad postoperative outcome. Within ERAS, use can be made of prehabilitation, which is the process of enhancing functional capacities to enable patients to withstand incoming stressors. Behavioral and lifestyle risk factors are modified to boost the physiological reserves to withstand the surgical stress response. Prehabilitation is made up of multiple components and is seen as a multimodal strategy. What patients require prehabilitation, is determined by examining the preoperative risk factors for developing postoperative complications. The postoperative outcome is used together with the type and number of risk factors for the assessment of patients’ need for prehabilitation. Univariate and multivariate logistic regressions are performed to collect information about the risk factors. Risk factors for age ≥70 years (OR 2.02, 95% CI 1.06-3.88), ASA-score >3 (OR 2.38, 95% CI 0.76-743), anemia (OR 2.81, 95% CI 1.35-5.85), severe pulmonary disease (OR 2.04, 95% CI 0.90-4.63) and recreational drug use (OR 4.21, 95% CI 0.58-30.64) are significant within the univariate logistic regression (p-value <0.20). After a backward elimination of the multivariate regression, anemia (OR 2.65, 95% CI 1.29-5.45) is left with an impact on the postoperative outcome. The univariate logistic regression for the number of risk factors shows a significantly higher risk for experiencing a bad postoperative outcome when having more than one (OR 3.14, 95% CI 1.25-7.84) or more than two (OR 9.84, 95% CI 2.54-38.20) risk factors compared with having no risk factors. Prehabilitation is therefore suggested in patients having anemia, and in patients who have two or more preoperative risk factors for developing complications. This will reduce the risk for having a bad postoperative outcome and optimize the postoperative recovery in patients.
Item Type:Essay (Bachelor)
Medisch Spectrum Twente
Faculty:TNW: Science and Technology
Subject:44 medicine
Programme:Health Sciences BSc (56553)
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