Background and Objectives: Colorectal cancer is a major contributor to global cancer morbidity and mortality. Surgical resection remains the cornerstone of treatment, but postoperative complications can significantly affect patient outcomes. Identifying factors that influence postoperative morbidity and mortality is crucial for optimizing patient care. This study aims to evaluate the impact of preoperative, intraoperative, and postoperative factors on surgical outcomes in patients with colorectal cancer. Methods: A retrospective cohort study was conducted on 688 patients who underwent colorectal cancer surgery within a 10-year period. Data collected included demographic information, comorbidities, laboratory values, surgical details, and postoperative outcomes. Statistical analyses were performed using chi-square tests for categorical variables and t-tests for continuous variables. Multivariate logistic regression was used to identify independent predictors of postoperative complications and mortality. Results: Postoperative complications occurred in 28.5% of patients, and the 30-day mortality rate was 5.2%. Preoperative factors such as elevated C-reactive protein (CRP) levels (p < 0.001), low albumin levels (p = 0.003), a high American Society of Anesthesiologists (ASA) score (p < 0.001), and presence of comorbidities like diabetes and hypertension (p = 0.005) were significantly associated with increased postoperative complications. Intraoperative factors such as blood loss greater than 500 mL (p < 0.001) and longer operative time (p = 0.021) were also significant predictors of adverse outcomes. Multivariate analysis identified elevated CRP (OR 2.1, 95% CI 1.5–2.9), low albumin (OR 1.8, 95% CI 1.3–2.5), and blood loss > 500 mL (OR 2.4, 95% CI 1.7–3.4) as independent predictors of postoperative complications. Conclusions: Preoperative inflammatory markers, nutritional status, ASA score, comorbidities, and intraoperative factors like blood loss significantly influence postoperative outcomes in colorectal cancer surgery. Recognizing these risk factors allows for better preoperative optimization and surgical planning, potentially reducing postoperative morbidity and mortality.

Background/Objectives: Perioperative anemia is common among patients undergoing major surgery and represents an important component of Patient Blood Management (PBM). However, real-world patterns of anemia documentation and management may vary across surgical settings. This study aimed to evaluate the prevalence and distribution of documented anemia and the recorded use of ferric carboxymaltose (FCM) and blood transfusion among major-surgery hospitalizations, comparing two consecutive years and different surgical categories. Methods: This retrospective observational study included 10,571 adult hospitalizations involving major surgical procedures at a Romanian tertiary emergency hospital between 1 January 2017 and 31 December 2018. Routinely collected administrative data were used to identify anemia diagnoses, recorded FCM administration, red blood cell (RBC) transfusion, and selected hospital resource utilization measures. Anemia diagnoses were checked against hemoglobin results documented in the medical records, and the anemia status was recorded as present or absent; individual hemoglobin values were not retained in the dataset. FCM administration and transfusion were recorded across the entire surgical population and could not be consistently linked to individual hospitalizations with documented anemia. Comparisons between years were performed using Pearson’s chi-square test, with effect sizes expressed as odds ratios and 95% confidence intervals. An exploratory analysis assessed length of stay, intensive care unit stay, and surgical duration according to recorded management patterns in selected orthopedic categories. Results: The study included 5370 hospitalizations in 2017 and 5201 in 2018. Documented anemia was recorded in 1514 (28.2%) and 1439 (27.7%) hospitalizations, respectively, showing a relatively stable overall prevalence but substantial variation across surgical categories. Recorded FCM administration decreased in 2018, whereas recorded blood transfusion increased. These frequencies refer to all surgical hospitalizations and do not necessarily represent interventions administered to the same hospitalizations in which anemia was documented. The relationship between documented anemia and recorded management events varied across procedure groups. Exploratory orthopedic analyses also indicated differences in hospital resource utilization between management groups, although interpretation was limited by small subgroup sizes and incomplete variability data. Conclusions: Documented anemia affected approximately one-quarter of major-surgery hospitalizations, while recorded management patterns differed by year and surgical category. These findings support procedure-sensitive clinical audits and more structured PBM pathways but do not establish treatment appropriateness or effectiveness.

Polyunsaturated fatty acids are involved in a wide variety of biological functions. Linoleic acid and alpha-linolenic acid are two essential fatty acids that the body cannot synthesize. The conversion rates in the body depend on FADS2 genetic variants. Certain variations in this gene are directly responsible for the low levels and poor conversion efficiency of the delta-6 desaturase enzyme, resulting in low circulating levels of docosahexaenoic acid. In this study, we evaluated the impact of the rs526126 FADS2 gene polymorphism on fatty acid levels in a group of two hundred children (n = 95 males, n = 105 females) aged 7–18 years, with obesity defined by BMI > +2 SD. Fatty acid quantification was performed by LC-MS/MS while genotyping for genetic variants was performed using a custom-made hotspot sequencing panel of 55 SNPs. Our results suggest that rs526126 FADS2 gene polymorphism specifically impacts the plasma levels of free n-3 polyunsaturated fatty acids. Finally, the presence of the minor allele G of rs526126 could have beneficial effects, as it was associated with higher levels of free docosahexaenoic acid in plasma, especially in children with low n-3 intakes.

Background and Objectives: This retrospective study aimed to evaluate the efficacy of preoperative blood transfusions in correcting anemia for pediatric patients with congenital malformations (CMs) versus those with acute abdomen (AA) conditions. The study hypothesized that the response to transfusions might vary significantly between these groups due to the differences in the underlying pathology and clinical status. Methods: The study included 107 pediatric patients admitted to Timisoara ‘Louis Turcanu’ Emergency Hospital for Children between January 2015 and May 2023, who required blood transfusions for preoperative anemia. Hemoglobin (HGB), hematocrit (HCT), and red blood cell counts (RBC) were assessed at admission, 48 h post-transfusion, and at discharge. Statistical analyses, including Student’s t-test, Pearson correlation, and chi-square tests, were utilized to compare outcomes between the groups. The study population was divided into 53 children with CM and 54 with AA. Results: Initial analyses showed that children with CM had statistically significantly higher baseline HGB (8.54 ± 1.00 g/dL vs. 7.87 ± 1.02 g/dL, p = 0.001) and HCT (26.07 ± 3.98% vs. 23.95 ± 2.90%, p = 0.002) compared to those with AA. Post-transfusion, children with CM exhibited a greater increase in HGB, with the highest increases noted in patients with central nervous system defects (mean increase of 3.67 g/dL, p = 0.038). In contrast, the increases in HGB for children with AA were less pronounced, with the highest being 2.03 g/dL in those with peritonitis (p = 0.078). Conclusions: No significant gender differences were noted in response to transfusion. Children with congenital malformations respond more effectively to preoperative blood transfusions compared to those with acute abdomen conditions. These findings suggest that differential transfusion strategies may be required based on the underlying medical condition to optimize the management of preoperative anemia in pediatric patients. Tailoring transfusion approaches according to specific patient needs and conditions could enhance clinical outcomes and resource utilization in pediatric surgical settings.

The COVID-19 pandemic exposed vulnerabilities in global blood supply systems and accelerated the adoption of patient blood management (PBM) strategies aimed at optimizing transfusion practices in surgical care. Perioperative anemia is a key contributor to adverse outcomes and is frequently treated with allogeneic blood transfusion (ABT), which carries infectious and immunologic risks. Iron deficiency remains the most common and potentially correctable cause of perioperative anemia. This narrative review examines various approaches to perioperative anemia, strategies to minimize reliance on ABT, and alternatives within the PBM paradigm. Evidence supports the use of iron therapy, erythropoiesis-stimulating agents, antifibrinolytic strategies, and blood conservation techniques to reduce transfusion requirements and improve clinical outcomes. Lessons from the COVID-19 pandemic highlight PBM as a framework to enhance transfusion safety and sustainability. Broader implementation of PBM may improve patient outcomes, reduce unnecessary transfusions, and preserve scarce blood resources.