Quick Search:

uzh logo
Browse by:
bullet
bullet
bullet
bullet

Zurich Open Repository and Archive 

Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-53795

Musallam, K M; Tamim, H M; Richards, T; Spahn, D R; Rosendaal, F R; Habbal, A; Khreiss, M; Dahdaleh, F S; Khavandi, K; Sfeir, P M; Soweid, A; Hoballah, J J; Taher, A T; Jamali, F R (2011). Preoperative anaemia and postoperative outcomes in non-cardiac surgery: a retrospective cohort study. Lancet, 378(9800):1396-1407.

[img]Published Version (English)
PDF - Registered users only
223kB
[img]Published Version
PDF (Supplementary webindex) - Registered users only
391kB

Abstract

BACKGROUND:

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.
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) 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.
FINDINGS:

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.
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.
FUNDING:

Vifor Pharma.

Copyright © 2011 Elsevier Ltd. All rights reserved.

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Institute of Anesthesiology
DDC:610 Medicine & health
Language:English
Date:2011
Deposited On:11 Jan 2012 21:46
Last Modified:01 Jun 2014 03:08
Publisher:Elsevier
ISSN:0140-6736
Additional Information:Comment in: Lancet. 2011 Oct 15;378(9800):1362-1363
Publisher DOI:10.1016/S0140-6736(11)61381-0
PubMed ID:21982521
Citations:Web of Science®. Times Cited: 75
Google Scholar™
Scopus®. Citation Count: 97

Users (please log in): suggest update or correction for this item

Repository Staff Only: item control page