The Association of Preoperative Hematocrit and Transfusion with Mortality in Patients Undergoing Elective Non-cardiac Surgery

被引:22
|
作者
Gabriel, Rodney A. [1 ,2 ]
Clark, Anthony I. [2 ]
Nguyen, Albert P. [2 ]
Waterman, Ruth S. [2 ]
Schmidt, Ulrich H. [2 ]
机构
[1] Univ Calif San Diego, Dept Biomed Informat, San Diego, CA 92093 USA
[2] Univ Calif San Diego, Dept Anesthesiol, 9500 Gilman Dr,MC 0881, San Diego, CA 92093 USA
关键词
BLOOD-CELL TRANSFUSION; RESTRICTIVE TRANSFUSION; POSTOPERATIVE OUTCOMES; 30-DAY MORTALITY; ANEMIA; MORBIDITY; STRATEGY; DISEASE;
D O I
10.1007/s00268-017-4359-y
中图分类号
R61 [外科手术学];
学科分类号
摘要
Patients with anemia frequently undergo surgery, as it is unclear at what threshold clinicians should consider delaying surgery for preoperative anemia optimization. The primary objective of this study was to determine whether there is an association of varying degrees of anemia and transfusion with 30-day mortality. This is a retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program database from 2011 to 2013. Cohorts were analyzed based on preoperative hematocrit range-patients with: (1) no anemia, (2) hematocrit ae33% and < 36% in females or < 39% in males, (3) hematocrit ae30% and < 33%, (4) hematocrit ae27% and < 30%, (5) hematocrit ae24% and < 27%, and (6) hematocrit ae21% and less than 24%. Multivariable logistic regression was used to analyze the association of anemia and transfusion with 30-day in-hospital mortality. The odds for 30-day mortality increased incrementally as the hematocrit ranges decreased, in which preoperative hematocrit between 21 and 24% had the highest odds for this outcome (odds ratio [OR] 6.50, p < 0.0001) compared to the reference group (no anemia). The use of transfusion increased the odds of mortality even further (OR 5.57, p < 0.0001). Among patients that received an intra-/postoperative transfusion, preoperative anemia was not predictive of mortality. Healthcare providers making preoperative clinical decisions for patients undergoing elective surgery should consider the degree of preoperative anemia and likelihood of perioperative transfusion.
引用
收藏
页码:1939 / 1948
页数:10
相关论文
共 50 条
  • [21] The cardiac consult for patients undergoing non-cardiac surgery
    Cohn, Steven L.
    HEART, 2016, 102 (16) : 1322 - 1332
  • [22] Association between preoperative resting heart rate and postoperative myocardial injury in patients undergoing non-cardiac surgery
    Abbott, T.
    Rodseth, R.
    Le Manach, Y.
    Ackland, G.
    Archbold, A.
    Wragg, A.
    Devereaux, P.
    Pearse, R.
    ANAESTHESIA, 2015, 70 : 28 - 28
  • [23] Elective non-cardiac Surgery in Patients with Underlying Disease
    Hoffmann, J. N.
    GEFASSCHIRURGIE, 2013, 18 (04): : 306 - 306
  • [24] Impact of Physical and Cognitive Frailty on Long-Term Mortality in Older Patients undergoing Elective Non-cardiac Surgery
    Low, Min-Jie
    Liau, Zhen Yi
    Cheong, Jun Leong
    San Loh, Pui
    Shariffuddin, Ina Ismiarti
    Khor, Hui Min
    ANNALS OF GERIATRIC MEDICINE AND RESEARCH, 2025, 29 (01): : 111 - 118
  • [25] Preoperative renal dysfunction and mortality after non-cardiac surgery
    Prowle, J. R.
    Kam, E. P. Y.
    Ahmad, T.
    Smith, N. C. E.
    Protopapa, K.
    Pearse, R. M.
    BRITISH JOURNAL OF SURGERY, 2016, 103 (10) : 1316 - 1325
  • [26] Preoperative evaluation of patients with, or at risk of, coronary artery disease undergoing non-cardiac surgery
    Chassot, PG
    Delabays, A
    Spahn, DR
    BRITISH JOURNAL OF ANAESTHESIA, 2002, 89 (05) : 747 - 759
  • [27] RISK STRATIFICATION OF PATIENTS UNDERGOING MAJOR NON-CARDIAC SURGERY AND IMPLICATIONS OF PREOPERATIVE ECHOCARDIOGRAPHY
    Shi, Yang
    Pedersen, Rachel
    Rappelt, Matthew W.
    Shearer, Robyn
    Sulemanjee, Nasir
    Zwicke, Dianne
    Hastings, Thomas
    Omar, Cheema
    Thohan, Vinay
    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2016, 67 (13) : 1458 - 1458
  • [28] Biomarker-Based Preoperative Risk Stratification for Patients Undergoing Non-Cardiac Surgery
    Yurttas, Timur
    Hidvegi, Reka
    Filipovic, Miodrag
    JOURNAL OF CLINICAL MEDICINE, 2020, 9 (02)
  • [29] Optimisation of preoperative anaemia in patients undergoing elective cardiac surgery
    Blunt, N.
    Balani, N.
    Hallward, G.
    McCorkell, S.
    Ghosh-Dastidar, M.
    Roxburgh, J.
    Bott, A.
    Duncombe, K.
    O'Sullivan, A.
    Radia, D.
    Kesse-Adu, R.
    Robinson, S.
    BRITISH JOURNAL OF HAEMATOLOGY, 2016, 173 : 159 - 159
  • [30] Anaesthesia for patients with cardiac disease undergoing non-cardiac surgery
    Bill, K. M.
    ANAESTHESIA AND INTENSIVE CARE MEDICINE, 2006, 7 (09): : 331 - 334