Background: Leukopenic patients have historically been considered poor surgical candidates due to a perceived increase in operative morbidity and mortality.
Methods: Retrospective cohort study using the NSQIP database to identify adult patients who received chemotherapy for malignancy within 30-days prior to elective or emergent abdominal surgery between 2008 and 2011. Leukopenia was defined as < 4000 WBC/mm3 within 2-days prior to surgery. Multiple logistic regression assessed if leukopenia was associated with morbidity and mortality.
Results: Of the 4369 patients included, 20.2% had preoperative leukopenia. Emergency cases comprised 36.2% of cases. Overall 30-day mortality was 12.2% and 30-day composite morbidity was 29.8%. After controlling for significant confounders, including emergency status, leukopenia was not significantly associated with either postoperative mortality (p = 0.14) or morbidity (p = 0.17).
Conclusions: Our study suggests that in cancer patients undergoing chemotherapy, leukopenia is not associated with morbidity or mortality and should not influence operative planning in either the elective or emergent setting.
Keywords: Chemotherapy; Elective; Emergent; Leukopenia; Malignancy.
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