“Preoperative anaemia and postoperative outcomes in non-cardiac surgery: a retrospective cohort study”

Preoperative anaemia and postoperative outcomes in non-cardiac surgery- a retrospective cohort study

www.thelancet.com Published online October 6, 2011 DOI:10.1016/S0140-6736(11)61381-0

“Methods We analysed data for patients undergoing major non-cardiac surgery in 2008 from The American College of Surgeons’ National Surgical Quality Improvement Program database (a prospective validated outcomes registry from 211 hospitals worldwide in 2008). We obtained anonymised data for 30-day mortality and morbidity (cardiac, respiratory, CNS, urinary tract, wound, sepsis, and venous thromboembolism outcomes), demographics, and preoperative and perioperative risk factors. We used multivariate logistic regression to assess the adjusted and modified (nine predefined risk factor subgroups) eff ect of anaemia, which was defi ned as mild (haematocrit concentration >29–<39% in men and >29–<36% in women) or moderate-to-severe (≤29% in men and women) on postoperative outcomes.

Interpretation Preoperative anaemia, even to a mild degree, is independently associated with an increased risk of 30-day morbidity and mortality in patients undergoing major non-cardiac surgery.”

Vascular patients were more anemic than others (no surprise there).  Any anemia in vascular surgery patients had OR for mortality = 1·44 (1·24–1·68) for morbidity 1·24 (1·14–1·35).

In all patient groups (by level of anemia or not), transfused patients did NOT have increase mortality or morbidity. Go figure.


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