{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T07:46:16Z","timestamp":1791963976378,"version":"4.3.4"},"reference-count":24,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Most studies evaluate perioperative hemoglobin at a single time point despite substantial changes across the perioperative period. We examined whether perioperative hemoglobin trajectory and perioperative hemoglobin decrease were associated with postoperative outcomes after major abdominal surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a secondary analysis of the international POSTVenTT cohort, a prospective multicentre observational study of adults undergoing major abdominal surgery. Hemoglobin trajectory was defined according to anemia status preoperatively and at hospital discharge. Perioperative hemoglobin decrease was defined as the difference between preoperative and discharge hemoglobin concentration. Mixed\u2010effects logistic regression models adjusted for predefined clinical covariates and center clustering were used to evaluate associations with postoperative complications, postoperative transfusion, and 30\u2010day readmission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 5302 patients, 3735 had both preoperative and discharge hemoglobin measurements and were included in trajectory analyses. Compared with patients without perioperative anemia, persistent anemia was associated with the higher odds of postoperative complications, postoperative transfusion, and 30\u2010day readmission, whereas new postoperative anemia showed similar but smaller associations. Greater perioperative hemoglobin decrease was associated with higher odds of postoperative complications. For each 10\u00a0g\/L decrease, the odds of any postoperative complication increased by 35% (OR 1.35, 95% CI 1.26\u20131.45) and major complication by 49% (OR 1.49, 1.35\u20131.64). Associations persisted after accounting for transfusion exposure and baseline hemoglobin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Perioperative hemoglobin trajectory and perioperative hemoglobin decrease were associated with postoperative complications and 30\u2010day readmission after major abdominal surgery. Greater hemoglobin decrease remained associated with adverse outcomes after accounting for transfusion exposure and baseline hemoglobin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>The POSTVenTT study was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12621001517864; 8 November 2021). The trial protocol was approved by the South Metropolitan Health Service (Western Australia) Health Research Ethics Committee (EC00265), the Western Australia Research Governance System (RCG 4477), with local ethics and governance confirmed at each site before patient recruitment<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70560","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:32:16Z","timestamp":1788417136000},"page":"2838-2847","source":"Crossref","is-referenced-by-count":0,"title":["Perioperative Hemoglobin Trajectory and Hemoglobin Decrease in Major Abdominal Surgery"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1958-9316","authenticated-orcid":false,"given":"Javier","family":"Ripoll\u00e9s\u2010Melchor","sequence":"first","affiliation":[{"name":"Hospital Universitario Infanta Leonor  Madrid Spain"},{"name":"Universidad Complutense de Madrid  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9644-2887","authenticated-orcid":false,"given":"Ane","family":"Abad\u2010Motos","sequence":"additional","affiliation":[{"name":"Hospital Universitario Donostia  San Sebasti\u00e1n Spain"},{"name":"PBM Working Group Spanish Society of Anaesthesia and Critical Care  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Jeric\u00f3","sequence":"additional","affiliation":[{"name":"Hospital Sant Joan Desp\u00ed\u2010Mois\u00e9s Broggi Consorci Sanitari Integral  Barcelona Spain"},{"name":"Grupo Espa\u00f1ol de Rehabilitaci\u00f3n Multimodal (GERM)  Zaragoza Spain"},{"name":"Grupo de Investigaci\u00f3n Gesti\u00f3n en el Paciente Sangrante\u2010PBM Instituto de Investigaci\u00f3n Sanitaria Hospital Universitaria La Paz (IdiPAZ)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9872-4653","authenticated-orcid":false,"given":"Toby","family":"Richards","sequence":"additional","affiliation":[{"name":"School of Health, Sport &amp; Bioscience UEL  London UK"},{"name":"Institute of Clinic Trials and Methodology UCL  London UK"},{"name":"Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2070-6871","authenticated-orcid":false,"given":"\u00c1ngel","family":"Espinosa","sequence":"additional","affiliation":[{"name":"Froedtert Hospital Medical College of Wisconsin  Milwakee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8322-6421","authenticated-orcid":false,"given":"Gianluca","family":"Pellino","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery Vall d'Hebron University Hospital Universitat Autonoma de Barcelona UAB Hospital Cl\u00ednico San Carlos  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Fern\u00e1ndez\u2010Garc\u00eda","sequence":"additional","affiliation":[{"name":"Hospital Universitario Infanta Leonor  Madrid Spain"},{"name":"Universidad Complutense de Madrid  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4414-2110","authenticated-orcid":false,"given":"Rosal\u00eda","family":"Navarro\u2010P\u00e9rez","sequence":"additional","affiliation":[{"name":"The University of Western Australia  Perth Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2831-4744","authenticated-orcid":false,"given":"Rachel","family":"Budithi","sequence":"additional","affiliation":[{"name":"Froedtert Hospital Medical College of Wisconsin  Milwakee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6822-6776","authenticated-orcid":false,"given":"Kenneth J.","family":"Macpherson","sequence":"additional","affiliation":[{"name":"Fiona Stanley Hospital  Perth Australia"},{"name":"Banco de Sangre y Tejidos de Navarra Servicio Navarro de Salud\u2010Osasunbidea  Pamplona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7662-6286","authenticated-orcid":false,"given":"Jos\u00e9 A.","family":"Garc\u00eda\u2010Erce","sequence":"additional","affiliation":[{"name":"Grupo Espa\u00f1ol de Rehabilitaci\u00f3n Multimodal (GERM)  Zaragoza Spain"},{"name":"Grupo de Investigaci\u00f3n Gesti\u00f3n en el Paciente Sangrante\u2010PBM Instituto de Investigaci\u00f3n Sanitaria Hospital Universitaria La Paz (IdiPAZ)  Madrid Spain"},{"name":"Grupo Espa\u00f1ol de Af\u00e9resis (GEA)  Madrid Spain"},{"name":"Instituto Aragon\u00e9s de Ciencias de la Salud (IACS)  Zaragoza Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Arag\u00f3n (IIS)  Zaragoza Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"POSTVenTT Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeu098"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2022.06.014"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2214\u2010109x(25)00320\u20101"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/eja.0000000000001412"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12871\u2010020\u201001024\u20108"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znae158"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2015.1704"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2017.05.113"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.15902"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"e_1_2_11_12_1","volume-title":"Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment of Severity. 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