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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Preoperative anaemia and postoperative outcomes in non-cardiac surgery: A retrospective cohort study
The Lancet, Volume 378, No. 9800, Year 2011
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Description
Preoperative anaemia is associated with adverse outcomes after cardiac surgery but outcomes after non-cardiac surgery are not well established. We aimed to assess the effect of preoperative anaemia on 30-day postoperative morbidity and mortality in patients undergoing major non-cardiac surgery. 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) effect of anaemia, which was defined 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. We obtained data for 227 425 patients, of whom 69 229 (30·44) had preoperative anaemia. After adjustment, postoperative mortality at 30 days was higher in patients with anaemia than in those without anaemia (odds ratio [OR] 1·42, 95 CI 1·31-1·54); this difference was consistent in mild anaemia (1·41, 1·30-1·53) and moderate-to-severe anaemia (1·44, 1·29-1·60). Composite postoperative morbidity at 30 days was also higher in patients with anaemia than in those without anaemia (adjusted OR 1·35, 1·30-1·40), again consistent in patients with mild anaemia (1·31, 1·26-1·36) and moderate-to-severe anaemia (1·56, 1·47-1·66). When compared with patients without anaemia or a defined risk factor, patients with anaemia and most risk factors had a higher adjusted OR for 30-day mortality and morbidity than did patients with either anaemia or the risk factor alone. 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. Vifor Pharma. © 2011 Elsevier Ltd.
Authors & Co-Authors
Musallam, Khaled M.
Lebanon, Beirut
American University of Beirut Medical Center
Italy, Milan
Fondazione Irccs Ca' Granda Ospedale Maggiore Policlinico
Tamim, Hani Mohammed
Lebanon, Beirut
American University of Beirut Medical Center
Saudi Arabia, Riyadh
College of Medicine-riyadh
Richards, Toby A.
United Kingdom, London
University College London Hospitals Nhs Foundation Trust
Spahn, Donat R.
Switzerland, Zurich
Universität Zürich
Rosendaal, Frits Richard
Netherlands, Leiden
Leids Universitair Medisch Centrum
Habbal, Aida
Lebanon, Beirut
American University of Beirut Medical Center
Khreiss, Mohammad
Lebanon, Beirut
American University of Beirut Medical Center
Dahdaleh, Fadi S.
Lebanon, Beirut
American University of Beirut Medical Center
Khavandi, Kaivan
United Kingdom, London
St Thomas' Hospital
Sfeir, Pierre M.
Lebanon, Beirut
American University of Beirut Medical Center
Soweid, Assaad M.
Lebanon, Beirut
American University of Beirut Medical Center
Hoballah, Jamal
Lebanon, Beirut
American University of Beirut Medical Center
Taher, Ali T.
Lebanon, Beirut
American University of Beirut Medical Center
Jamali, Faek R.
Lebanon, Beirut
American University of Beirut Medical Center
Statistics
Citations: 972
Authors: 14
Affiliations: 7
Identifiers
Doi:
10.1016/S0140-6736(11)61381-0
ISSN:
01406736
e-ISSN:
1474547X
Research Areas
Health System And Policy
Noncommunicable Diseases
Study Design
Cohort Study
Case-Control Study
Study Approach
Quantitative
Participants Gender
Male
Female