TY  - JOUR
A1  - Judd, L.
A1  - Hof, L.
A1  - Beladdale, L.
A1  - Friederich, P.
A1  - Thoma, J.
A1  - Wittmann, M.
A1  - Zacharowski, K.
A1  - Meybohm, P.
A1  - Choorapoikayil, S.
T1  - Prevalence of pre-operative anaemia in surgical patients: a retrospective, observational, multicentre study in Germany
JF  - Anaesthesia
N2  - Anaemia is a risk factor for several adverse postoperative outcomes. Detailed data about the prevalence of anaemia are not available over a long time-period in Germany. In this retrospective, observational, multicentre study, patients undergoing surgery in March in 2007, 2012, 2015, 2017 and 2019 were studied. The primary objective was the prevalence of anaemia at hospital admission. The secondary objectives were the association between anaemia and the number of units of red blood cells transfused, length of hospital stay and in-hospital mortality. A total of 23,836 patients were included from eight centres. The prevalence of pre-operative anaemia in patients aged ≥ 18 years decreased slightly from 37% in 2007 to 32.5% in 2019 (p = 0.01) and increased in patients aged ≤ 18 years from 18.8% in 2007 to 26.4% in 2019 (p > 0.001). The total amount of blood administered per 1000 patients decreased from 671.2 units in 2007 to 289.0 units in 2019. Transfusion rates in anaemic patients declined from 33.8% in 2007 to 19.1% in 2019 (p < 0.001) and in non-anaemic patients from 8.4% in 2007 to 3.4% in 2019 (p < 0.001). Overall, the mortality rate remained constant over the years: 2.9% in 2007, 2.1% in 2012, 2.5% in 2015, 1.9% in 2017 and 2.5% in 2019. In the presence of anaemia, mortality was significantly increased compared with patients without anaemia (OR 5.27 (95%CI 4.13–6.77); p < 0.001). Red blood cell transfusion was associated with an increased risk of mortality (OR 14.98 (95%CI 11.83–19.03); p < 0.001). Using multivariable linear regression analysis with fixed effects, we found that pre-operative anaemia (OR 2.08 (95%CI 1.42–3.05); p < 0.001) and red blood cell transfusion (OR 4.29 (95%CI 3.09–5.94); p < 0.001) were predictors of mortality but not length of stay (0.99 (95%CI 0.98–1.00) days; p = 0.12) and analysed years (2007 vs. 2019: OR 1.49 (95%CI 0.86–2.69); p = 0.07). Pre-operative anaemia affects more than 30% of surgical patients in Germany and multidisciplinary action is urgently required to reduce adverse outcomes.
KW  - anaemia
KW  - surgery
KW  - prevalence
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-318199
VL  - 77
IS  - 11
SP  - 1209
EP  - 1218
ER  - 
TY  - JOUR
A1  - Lueken, U
A1  - Kuhn, M
A1  - Yang, Y
A1  - Straube, B
A1  - Kircher, T
A1  - Wittchen, H-U
A1  - Pfleiderer, B
A1  - Arolt, V
A1  - Wittmann, A
A1  - Ströhle, A
A1  - Weber, H
A1  - Reif, A
A1  - Domschke, K
A1  - Deckert, J
A1  - Lonsdorf, TB
T1  - Modulation of defensive reactivity by GLRB allelic variation: converging evidence from an intermediate phenotype approach
JF  - Translational Psychiatry
N2  - Representing a phylogenetically old and very basic mechanism of inhibitory neurotransmission, glycine receptors have been implicated in the modulation of behavioral components underlying defensive responding toward threat. As one of the first findings being confirmed by genome-wide association studies for the phenotype of panic disorder and agoraphobia, allelic variation in a gene coding for the glycine receptor beta subunit (GLRB) has recently been associated with increased neural fear network activation and enhanced acoustic startle reflexes. On the basis of two independent healthy control samples, we here aimed to further explore the functional significance of the GLRB genotype (rs7688285) by employing an intermediate phenotype approach. We focused on the phenotype of defensive system reactivity across the levels of brain function, structure, and physiology. Converging evidence across both samples was found for increased neurofunctional activation in the (anterior) insular cortex in GLRB risk allele carriers and altered fear conditioning as a function of genotype. The robustness of GLRB effects is demonstrated by consistent findings across different experimental fear conditioning paradigms and recording sites. Altogether, findings provide translational evidence for glycine neurotransmission as a modulator of the brain’s evolutionary old dynamic defensive system and provide further support for a strong, biologically plausible candidate intermediate phenotype of defensive reactivity. As such, glycine-dependent neurotransmission may open up new avenues for mechanistic research on the etiopathogenesis of fear and anxiety disorders.
KW  - glycine receptor beta subunit
KW  - neural fear network activation
KW  - intermediate phenotype approach
KW  - defensive system reactivity
Y1  - 2017
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-182381
VL  - 7
IS  - e1227
ER  -