Abstract
BackgroundEvidence regarding the relationship between anemia and perioperative prognosis is controversial. The study was conducted to highlight the specific relationship between anemia and perioperative mortality in non-cardiac surgery patients over 18 years of age.MethodsThis study was a retrospective analysis of the electronic medical records of 90,784 patients at the Singapore General Hospital from January 1, 2012 to October 31, 2016. Multivariate regression, propensity score analysis, doubly robust estimation, and an inverse probability-weighting model was used to ensure the robustness of our findings.ResultsWe identified 85,989 patients, of whom75, 163 had none or mild anemia (Hemoglobin>90g/L) and 10,826 had moderate or severe anemia (Hemoglobin≤90g/L). 8,857 patients in each study exposure group had similar propensity scores and were included in the analyses. In the doubly robust model, postoperative 30-day mortality rate was increased by 0.51% (n = 219) in moderate or severe anemia group (Odds Ratio, 1.510; 95% Confidence Interval (CI), 1.049 to 2.174) compared with none or mild anemia group (2.47% vs.1.22%, P<0.001). Moderate or severe anemia was also associated with increased postoperative blood transfusion rates (OR, 5.608; 95% CI, 4.026 to 7.811, P < 0.001). There was no statistical difference in Intensive Care Unit (ICU) admission rate among different anemia groups within 30 days after surgery (P=0.104).DiscussionIn patients undergoing non-cardiac surgery over 18 years old, moderate or severe preoperative anemia would increase the occurrence of postoperative blood transfusion and the risk of death, rather than ICU admission within 30 days after surgery.
Highlights
Evidence regarding the relationship between anemia and perioperative prognosis is controversial
The selection of participants After excluding 4,037 cases with missing data of anemia status and 758 cases under 18 years of age, the study's initial cohort was recruited the initial cohort for this study was recruited(N = 85 989;mean± age:53.17 ± 16.67 years; 54.25%female ).There were 75,163 (87.4%) patients with none or mild anemia, and 10,826 (12.6%) patients with moderate or severe anemia (Fig. 1).One-to-one propensity score matching yielded 22,702 patients, with 8857 patients in each study exposure group
Baseline characteristics of participants Prior to the propensity score matching, we found that in the moderate or severe anemia group, patients were usually older, more women, more frequent preoperative and intraoperative blood transfusions, higher Red Cell Distribution Width (RDW), and a higher incidence of comorbidities,emergency surgery with higher surgical risk
Summary
Evidence regarding the relationship between anemia and perioperative prognosis is controversial. The study was conducted to highlight the specific relationship between anemia and perioperative mortality in noncardiac surgery patients over 18 years of age. There is controversy of the relationship between anemia and perioperative prognosis, such as postoperative 30day mortality. Little is known about the effects of anemia in the perioperative prognosis in non-cardiac surgery patients over 18 years of age, with two related studies involving children [14] and the elderly [15]. Our study aimed to investigate the relationship between different anemia status and perioperative prognosis in noncardiac surgery adult patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
