Preoperative anemia increases mortality and postoperative morbidity after cardiac surgery

Antonio Miceli, Francesco Romeo, Mattia Glauber, Paolo M. de Siena, Massimo Caputo, Gianni D. Angelini

Research output: Contribution to journalArticle

Abstract

Background: Anemia is an established adverse risk factor in cardiovascular disease. However, the effect of preoperative anemia is not well defined in heart surgery. This study evaluates the effect of preoperative anemia on early clinical outcomes in patients undergoing cardiac surgery.Methods: A retrospective, observational, cohort study of prospectively collected data was undertaken on 7,738 consecutive patients undergoing heart surgery between April 2003 and February 2009. Of these, 1,856 patients with preoperative anemia were compared to 5,882 patients without anemia (control group). According to the World Health Organization, anemia was defined as hemoglobin level < 13 g/dl for men and <12 g/dl for women. Selection bias not controlled by multivariable methods was assessed with propensity-adjustment method.Results: Overall mortality was 2.1%. Preoperative anemia was associated with tripling in the risk of death (4.6% vs 1.5%, p < 0.0001) and postoperative renal dysfunction (18.5% vs 6.5%, p < 0.0001). There was also a significant difference between the anemic and non-anemic group in the risk of postoperative stroke (1.9% vs 1.1%, p = 0.008), atrial fibrillation (36.7% vs 33%, p = 0.003) and length of hospital stay > 7 days (54% vs 36.7%, p < 0.0001). In propensity-adjusted, multivariable logistic regression, preoperative anemia was an independent predictor of mortality (odds ratio [OR] 1.44, 95% confidence interval [CI] 1.02 to 2.03), postoperative renal dysfunction (OR 1.73, 95% CI 1.43 to 2.1) and length of hospital stay > 7 days (OR 1.3, 95% CI 1.15 to 1.47).Conclusion: In patients undergoing heart surgery, preoperative anemia is associated with an increased risk of mortality and postoperative morbidity.

Original languageEnglish
Article number137
JournalJournal of Cardiothoracic Surgery
Volume9
Issue number1
DOIs
Publication statusPublished - Aug 5 2014

Keywords

  • Anemia
  • Cardiac surgery
  • Outcome

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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    Miceli, A., Romeo, F., Glauber, M., de Siena, P. M., Caputo, M., & Angelini, G. D. (2014). Preoperative anemia increases mortality and postoperative morbidity after cardiac surgery. Journal of Cardiothoracic Surgery, 9(1), [137]. https://doi.org/10.1186/1749-8090-9-137