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Br J Anaesth. 2014 Sep;113(3):416-23. doi: 10.1093/bja/aeu098. Epub 2014 May 14.

Preoperative anaemia is associated with poor clinical outcome in non-cardiac surgery patients.

Author information

1
Department of Anaesthesia, General Intensive Care and Pain Management, Medical University of Vienna, Vienna, Austria.
2
Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
3
Austrian Center for Documentation and Quality Management in Intensive Care Medicine, Vienna, Austria.
4
Intensive Care Medicine, St Georges Healthcare NHS Trust and St Georges University of London, St Georges Hospital, London, UK philipp@metnitz.biz andrewrhodes@nhs.net.
5
UCINC, Hospital de São José, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal.
6
Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
7
Department of Anaesthesia, General Intensive Care and Pain Management, Medical University of Vienna, Vienna, Austria philipp@metnitz.biz andrewrhodes@nhs.net.

Abstract

BACKGROUND:

Retrospective studies suggest that preoperative anaemia is associated with poor outcomes after surgery. The objective of this study was to describe mortality rates and patterns of intensive care resource use for patients with anaemia undergoing non-cardiac and non-neurological in-patient surgery.

METHODS:

We performed a secondary analysis of a large prospective study describing perioperative care and survival in 28 European nations. Patients at least 16 yr old undergoing in-patient surgery during a 7 day period were included in the study. Data were collected for in-hospital mortality, duration of hospital stay, admission to intensive care, and intensive care resource use. Multivariable logistic regression analysis was performed to understand the effects of preoperative haemoglobin (Hb) levels on in-hospital mortality.

RESULTS:

We included 39 309 patients in the analysis. Preoperative anaemia had a high prevalence in both men and women (31.1% and 26.5%, respectively). Multivariate analysis showed that patients with severe [odds ratio 2.82 (95% confidence interval 2.06-3.85)] or moderate [1.99 (1.67-2.37)] anaemia had higher in-hospital mortality than those with normal preoperative Hb concentrations. Furthermore, hospital length of stay (P<0.001) and postoperative admission to intensive care (P<0.001) were greater in patients with anaemia than in those with normal Hb concentrations.

CONCLUSIONS:

Anaemia is common among non-cardiac and non-neurological surgical patients, and is associated with poor clinical outcome and increased healthcare resource use.

CLINICAL TRIAL REGISTRATION:

NCT01203605 (ClinicalTrials.gov).

KEYWORDS:

anaemia; assessment, outcome; care, intensive; epidemiologic studies, cohort studies; mortality determinants

PMID:
24829444
DOI:
10.1093/bja/aeu098
[Indexed for MEDLINE]
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