Supplement
eFigure 1. Flow chart of enrollment
eFigure 2. Subgroup analysis of association between Postoperative Hb drift and overall survival
eTable 1. Preoperative Factors Associated with the Postoperative Hb drift
eTable 2. Factors Associated with the Postoperative mortality at 30 days eTable 3. Patient Characteristics Before and After Propensity Score Matching
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eFigure 1 Flow chart of enrollment
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eFigure 2. Subgroup analysis of association between Postoperative Hb drift and overall survival
SBP: systolic blood pressure; ASA: American Society of Anesthesiologists.
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eTable 1 Factors Associated with the Postoperative Hb drift
Characteristics Univariable Multivariable
OR (95% CI) P OR (95% CI) P
Demographics
Age, year 1.00(1.00-1.01) 0.10 1.01(1.00-1.01) <0.001
Female, n (%) 1.28(1.15-1.42) <0.001 1.33(1.18-1.50) <0.001
Smoking (%) 0.75(0.63-0.89) 0.001 0.71(0.59-0.86) <0.001
Alcohol, n (%) 0.89(0.77-1.03) 0.11 NA NA
Medical history, n (%)
Hypertension 0.94(0.82-1.08) 0.37 NA NA
Diabetes 1.15(0.96-1.38) 0.13 NA NA
Chronic liver disease 0.96(0.76-1.20) 0.69 NA NA
Coronary artery disease 1.33(0.84-2.10) 0.23 NA NA
ASA class IV-V 1.77(1.38-2.27) <0.001 1.41(1.09-1.83) 0.01 Type of brain tumor, n (%)
Benign 1 [Reference] 1 [Reference]
Uncertain behavior 1.22(1.04-1.44) 0.02 1.32(1.10-1.58) 0.003 Malignant 1.24(1.11-1.39) <0.001 1.40(1.22-1.62) <0.001 Preoperative SBP, mmHg 0.99(0.99-1.00) 0.002 0.99(0.99-1.00) 0.001 Preoperative laboratory
Hemoglobin, g/L 1.00(1.00-1.00) 0.79 NA NA
Platelet, 109/L 1.00(1.00-1.00) 0.71 NA NA
International normalized ratio 1.86(0.91-3.78) 0.09 0.54(0.24-1.23) 0.14
Prothrombin time, s 1.03(0.96-1.09) 0.40 NA NA
Activated partial thromboplastin time
, s 0.99(0.97-1.00) 0.06 1.01(1.00-1.03) 0.12
Preoperative anti-
coagulant/platelet drugs 1.24(0.92-1.66) 0.15 NA NA
Intraoperative, mean (SD)
Surgery time, hours 1.21(1.18-1.24) <0.001 1.12(1.08-1.16) <0.001 Blood loss, ml 1.00(1.00-1.00) <0.001 1.00(1.00-1.00) <0.001 Grade of resection
Subtotal resection 1 [Reference] 1 [Reference]
Gross total resection 0.89(0.79-1.00) 0.05 1.02(0.88-1.17) 0.81 Daily fluid volume on PODs 1-3, ml
Mannitol 1.00(1.00-1.00) <0.001 1.00(1.00-1.00) <0.001 Fluid use 1.00(1.00-1.00) <0.001 1.00(1.00-1.00) <0.001 SBP: systolic blood pressure; ASA: American Society of Anesthesiologists; NA: not available; POD:
postoperative day
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Postoperative Hb drift defined as ΔHb >25%
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eTable 2 Factors Associated with the Postoperative mortality at 30
days
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Characteristics Univariable Multivariable
OR (95% CI) P OR (95% CI) P
Demographics
Age, year 0.99(0.98-1.01) 0.34 NA NA
Female, n (%) 0.70(0.52-0.96) 0.03 NA NA
Smoking (%) 1.07(0.67-1.72) 0.77 NA NA
Alcohol, n (%) 1.07(0.71-1.61) 0.76 NA NA
Medical history, n (%)
Hypertension 0.65(0.40-1.05) 0.08 0.65(0.39-
1.08) 0.10
Diabetes 0.96(0.54-1.70) 0.88 NA NA
Chronic liver disease 1.07(0.56-2.04) 0.84 NA NA
Coronary artery disease 2.24(0.81-6.19) 0.12 NA NA
ASA class IV-V 5.09(3.27-7.92) <0.00
1 3.06(1.87-
5.00) <0.00
1 Type of brain tumor, n (%)
Benign 1 [Reference] 1 [Reference]
Uncertain behavior 1.79(1.07-2.99) 0.03 1.57(0.90-
2.74) 0.11
Malignant 3.09(2.21-4.33) <0.00
1 3.08(2.14-
4.43) <0.00
1 Preoperative systolic blood pressure,
mmHg 1.00(0.99-1.01) 0.69 NA NA
Preoperative laboratory
Hemoglobin, g/L 1.02(1.01-1.03) 0.003 1.01(1.00-
1.02) 0.15
Platelet, 109/L 1.00(1.00-1.00) 0.40 NA NA
International normalized ratio 11.92(1.69- 84.34) 0.01 NA NA
Prothrombin time, s 1.21(1.02-1.44) 0.03 NA NA
Activated partial thromboplastin tim
e, s 0.96(0.92-1.01) 0.10 NA NA
Preoperative anti-
coagulant/platelet drugs 1.52(0.70- 3.28) 0.29 NA NA
Intraoperative, mean (SD)
Surgery time, hours 1.22(1.16-1.30) <0.00
1 1.13(1.05-
1.21) <0.00
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Blood loss, ml 1.00(1.00-1.00) <0.00
1 NA NA
Grade of resection
Subtotal resection 1 [Reference] 1 [Reference]
Gross total resection 0.56(0.41-0.78) <0.00
1 NA NA
Daily fluid volume on postoperative day 1-3, ml
Mannitol 1.00(1.00-1.00) <0.00
1 1.00(1.00-
1.00) 0.002
Fluid use 1.00(1.00- 1.00) <0.00
1 1.00(1.00-
1.00) <0.00
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Transfusion 5.98(4.09- 8.74) <0.00
1 2.13(1.33-
3.41) 0.002
ΔHb
≤25% 1 [Reference] 1 [Reference]
26-50% 4.13(2.95-5.78) <0.00
1 2.47(1.72-
3.56) <0.00
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51-75% 17.98(10.50- <0.00 6.56(3.42- <0.00
eTable 3 Patient Characteristics Before and After Propensity Score
Matching
Before matching After matching
Characteristics ΔHb ≤25%
(n = 6122)
ΔHb >25%
(n =2037) SMD ΔHb ≤25%
(n = 1802)
ΔHb >25%
(n =1802) SMD Demographics
Age, year, mean (SD) 49.43 (13.00) 50.08 (14.32) 0.047 49.72 (13.46) 49.99 (14.25) 0.019
Female, n (%) 3179 (51.9) 1158 (56.8) 0.099 1041 (57.8) 1011 (56.1) 0.034
Smoking, n (%) 731 (11.9) 194 (9.5) 0.078 177 (9.8) 174 (9.7) 0.006
Alcohol, n (%) 1000 (16.3) 307 (15.1) 0.035 284 (15.8) 277 (15.4) 0.011
Medical history, n (%)
Hypertension 1024 (16.7) 327 (16.1) 0.018 270 (15.0) 280 (15.5) 0.015
Diabetes 467 (7.6) 197 (9.7) 0.073 162 (9.0) 163 (9.0) 0.002
Chronic liver disease 346 (5.7) 117 (5.7) 0.004 97 (5.4) 101 (5.6) 0.01
Coronary artery disease 62 (1.0) 29 (1.4) 0.037 24 (1.3) 26 (1.4) 0.009
ASA class IV-V, n (%) 180 (2.9) 114 (5.6) 0.132 91 (5.0) 87 (4.8) 0.01
Type of brain tumor, n (%) 0.116 0.005
Benign 3617 (59.1) 1087 (53.4) 962 (53.4) 964 (53.5)
Uncertain behavior 685 (11.2) 264 (13.0) 223 (12.4) 225 (12.5)
Malignant 1820 (29.7) 686 (33.7) 617 (34.2) 613 (34.0)
Preoperative SBP, mmHg, mean
(SD) 126.46 (15.71) 125.03 (16.96) 0.088 124.63 (15.20) 124.97 (17.01) 0.021
Preoperative laboratory, mean (SD)
Hemoglobin, g/L 139.80 (11.98) 140.17 (12.10) 0.031 140.00 (12.30) 140.24 (12.07) 0.02 Platelet, 109/L 185.11 (55.82) 185.01 (57.21) 0.002 185.08 (57.16) 185.00 (57.66) 0.001 International normalized ratio 0.97 (0.07) 0.97 (0.08) 0.058 0.97 (0.07) 0.97 (0.08) 0.001 Prothrombin time, s 11.02 (0.79) 11.04 (0.86) 0.032 11.05 (0.77) 11.04 (0.86) 0.012
APTT, s 27.25 (3.55) 27.08 (3.88) 0.046 27.11 (3.67) 27.09 (3.84) 0.004
Anti-coagulant/platelet drugs, n (%) 161 (2.6) 71 (3.5) 0.05 65 (3.6) 56 (3.1) 0.028 Intraoperative, mean (SD)
Surgery time, hours 3.47 (1.69) 4.22 (2.20) 0.379 4.10 (2.09) 4.05 (1.96) 0.023
Blood loss, ml 231 (364) 454 (622) 0.437 373 (568) 364 (476) 0.017
Gross total resection 4598 (75.1) 1486 (73.0) 0.049 1320 (73.3) 1320 (73.3) <0.001 Daily fluid volume on PODs 1-3,
ml, mean (SD)
Mannitol 392 (432) 541 (589) 0.288 506 (484) 506 (548) 0.001
Fluid use 1342(1130) 2051 (1803) 0.471 1857(1337) 1828(15489) 0.02
Transfusion, n (%) 113 (1.8) 290 (14.2) 0.468 112 (6.2) 135 (7.5) 0.051
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SBP: systolic blood pressure; ASA: American Society of Anesthesiologists; POD: postoperative day;
NA: not available; APTT: Activated partial thromboplastin time 24
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