Impact Of Preoperative Anemia Research Articles

Impact of preoperative anemia and perioperative transfusion on short‐term outcomes in colorectal cancer surgery: The role of iron supplementation

Impact of preoperative anemia and perioperative transfusion on short‐term outcomes in colorectal cancer surgery: The role of iron supplementation

Impact of preoperative anemia on patients undergoing total joint replacement of lower extremity: a systematic review and meta-analysis

sPurposePreoperative anemia increases postoperative morbidity, mortality, and the risk of allogeneic transfusion. However, the incidence of preoperative anemia in patients undergoing total hip arthroplasty and total knee arthroplasty (TKA) and its relationship to postoperative outcomes has not been previously reported.MethodsWe conducted a comprehensive literature search through PubMed, Cochrane Library, Web of Sincien, and Embase from inception to July 2023 to investigate the prevalence of preoperative anemia in patients undergoing Total Joint Arthroplasty, comorbidities between anemic and non-anemicpatients before surgery, and postoperative outcomes. postoperative outcomes were analyzed. Overall prevalence was calculated using a random-effects model, and heterogeneity between studies was examined by Cochran's Q test and quantified by the I2 statistic. Subgroup analyses and meta-regression analyses were performed to identify sources of heterogeneity. Publication bias was assessed by funnel plots and validated by Egger's test.ResultsA total of 21 studies with 369,101 samples were included, all of which were retrospective cohort studies. 3 studies were of high quality and 18 studies were of moderate quality. The results showed that the prevalence of preoperative anemia was 22% in patients awaiting arthroplasty; subgroup analyses revealed that the prevalence of preoperative anemia was highest in patients awaiting revision of total knee arthroplasty; the highest prevalence of preoperative anemia was found in the Americas; preoperative anemia was more prevalent in the female than in the male population; and preoperative anemia with a history of preoperative anemia was more common in the female than in the male population. patients with a history of preoperative anemia; patients with joint replacement who had a history of preoperative anemia had an increased risk of infection, postoperative blood transfusion rate, postoperative blood transfusion, Deep vein thrombosis of the lower limbs, days in hospital, readmission within three months, and mortality compared with patients who did not have preoperative anemia.ConclusionThe prevalence of preoperative anemia in patients awaiting total joint arthroplasty is 22%, and is higher in TKA and female patients undergoing revision, while preoperative anemia is detrimental to the patient's postoperative recovery and will increase the risk of postoperative complications, transfusion rates, days in the hospital, readmission rates, and mortality.

Pre-operative Anemia as a Risk Factor of Morbidity and Mortality in Valvular Surgeries

Pre-operative anemia can be a hindrance to speedy recovery and will increase blood transfusion intraoperative and post operatively. Objective: To find a correlation between preoperative anemia and the subsequent morbidity and mortality rates in patients undergoing valvular surgeries. Methods: A retrospective observational study, involving 493 valvular surgeries’ patients. All patients had the same anesthetic and surgical techniques. According to the WHO, anemia is a hemoglobin level < 13 g/dl for men and <12 g/dl for women. Clinical variables were compared using chi-square and independent t-test. Results: The patients received cardiac surgery for valvular heart disorders and had an average age of 42.2±14.1 years, with 60.9% being male. Most patients exhibited NYHA III (48.9%) and CCS III (36.5%) functional class symptoms. Highest comorbidity was hypertension (35.1%), followed by diabetes (14.4%) and dyslipidemia (6.5%). 43.2% were anemic and older than non-anemic individuals (P=0.02). Anemic people had a significantly greater incidence of HTN (P 0.02) and DM (P < 0.001). Both groups exhibited identical perfusion and cross-clamp periods (P=0.4 vs. P=0.3). Though not statistically significant (P=0.08), non-anemic patients needed more intraoperative blood or blood product transfusions. Patients with anemia have worse outcomes, including increased rates of in-hospital mortality (P=0.03), extended artificial breathing (P=0.04), and postoperative blood/product transfusion (P<0.001). 44.8% of anemic individuals needed RCC, 41.9% FFP, and 41.4% platelets. Conclusions: anemia is associated with the poorest post-operative results. There is conflicting information about the impact of preoperative anemia, particularly iron deficiency anemia, on valvular surgery.

The Impact of Pre-Operative Anaemia on One Year Amputation Free Survival and Re-Admissions in Patients Undergoing Vascular Surgery for Peripheral Arterial Disease: A National Vascular Registry Study

The Impact of Pre-Operative Anaemia on One Year Amputation Free Survival and Re-Admissions in Patients Undergoing Vascular Surgery for Peripheral Arterial Disease: A National Vascular Registry Study

Impact of preo-perative anaemia on elective patients

Impact of preo-perative anaemia on elective patients

The Impact of Pre-Operative Anaemia on One Year Amputation Free Survival and Re-Admissions in Patients Undergoing Vascular Surgery for Peripheral Arterial Disease: a National Vascular Registry Study

Anaemia is common among patients undergoing surgery, but its association with post-operative outcomes in patients with peripheral arterial disease (PAD) is unclear. The aim of this observational population based study was to examine the association between pre-operative anaemia and one year outcomes after surgical revascularisation for PAD. This study used data from the National Vascular Registry, linked with an administrative database (Hospital Episode Statistics), to identify patients who underwent open surgical lower limb revascularisation for PAD in English NHS hospitals between January 2016 and December 2019. The primary outcome was one year amputation free survival. Secondary outcomes were one year re-admission rate, 30 day re-intervention rate, 30 day ipsilateral major amputation rate and 30 day death. Flexible parametric survival analysis and generalised linear regression were performed to assess the effect of anaemia on one year outcomes. The analysis included 13 641 patients, 57.9% of whom had no anaemia, 23.8% mild, and 18.3% moderate or severe anaemia. At one year follow up, 80.6% of patients were alive and amputation free. The risk of one year amputation or death was elevated in patients with mild anaemia (adjusted HR 1.3; 95% CI 1.15 - 1.41) and moderate or severe anaemia (aHR 1.5; 1.33 - 1.67). Patients with moderate or severe anaemia experienced more re-admissions over one year (adjusted IRR 1.31; 1.26 - 1.37) and had higher odds of 30 day re-interventions (aOR 1.22; 1.04 - 1.45), 30 day ipsilateral major amputation (aOR 1.53; 1.17 - 2.01), and 30 day death (aOR 1.39; 1.03 - 1.88) compared with patients with no anaemia. Pre-operative anaemia is associated with lower one year amputation free survival and higher one year re-admission rates following surgical revascularisation in patients with PAD. Research is required to evaluate whether interventions to correct anaemia improve outcomes after lower limb revascularisation.

Impact of Preoperative Anemia on Hospitalization, Death, and Overall Survival in Patients With Peripheral Artery Disease Undergoing Endovascular Therapy: A Retrospective Cohort Study in the United States and Canada

Purpose: Preoperative anemia is associated with adverse outcomes after cardiac and noncardiac surgeries, but outcomes after an endovascular peripheral vascular intervention (PVI) are not well established. We aimed to assess the association of preoperative anemia with 30 day death, hospital length of stay (LOS), and overall (long term) survival in patients undergoing an endovascular PVI for peripheral artery disease. Materials and Methods: In this retrospective, cohort study in the United States and Canada, we queried the national Vascular Quality Initiative database for all endovascular PVIs performed between 2010 and 2019, and outcomes were correlated with patients’ hemoglobin (Hb) levels. Anemia was classified as mild (Hb=10–13 g/dL for men and 10–12 g/dL for women), moderate (Hb=8–9.9 g/dL), and severe (Hb<8 g/dL). Results: A total of 79 707 adult patients who met study criteria underwent endovascular PVI. The mean age was 68 years, and 59% of patients were male. Anemia was documented in 38 543 patients (48%) and was mild in 27 435 (71%), moderate in 9783 (25%), and severe in 1325 (4%). The median follow-up duration was 4 years (range, 1.25–5.78 years). On univariate analysis, 30 day mortality, total LOS, and overall survival were significantly associated with the level of preoperative anemia. These associations persisted in the multivariate models. Kaplan-Meier survival analysis demonstrated an association of death with degree of anemia (p<0.001). Conclusion: The presence and degree of preoperative anemia were independently associated with increased 30 day mortality and LOS and decreased overall survival for patients with peripheral artery disease who had undergone endovascular PVI. Clinical Impact: The findings from this study have many implications for how to approach vascular surgery in patients with variable hemoglobin levels. Our findings will strengthen our ability to conduct accurate preoperative risk stratification for patients undergoing peripheral vascular interventions. This may also mitigate healthcare expenditures if findings are applied in a way that can lower patient length of postoperative stay while also maintaining quality of care and patient safety. Our results will also serve as guidance for clinical trials, and future prospective trials should evaluate the effect of preoperative optimization of hemoglobin as a potentially modifiable risk factor for outcomes.

Preoperative Anemia is Associated with Poorer Postoperative Outcomes in Patients Undergoing Infrainguinal Bypass Surgery

Preoperative anemia is an important, modifiable risk factor among surgical patients. However, data are scarce on the impact of preoperative anemia on postoperative outcomes after infrainguinal bypass. In this multi-institutional analysis, data were retrospectively collected on all infrainguinal bypass procedures performed between 2010 and 2020. Patients were grouped by preoperative hemoglobin as per the National Cancer Institute anemia scale (mild, 10g/dL-lower limit of normal; moderate, 8.0-9.9g/dL; severe, 6.5-7.9g/dL). Multivariable comparisons were performed using logistic regression analysis. A total of 492 patients underwent bypass for peripheral artery disease over the 10-year study period. Median preoperative hemoglobin was 11.0g/dL (interquartile range 9.5-12.7) and median follow-up was 1.7years. Preoperative anemia was prevalent among bypass patients (mild 52.4% [n=258], moderate 26.4% [n=130], and severe 5.1% [n=25]). Women were more likely to have moderate (49.2% [women] vs. 50.8% [men]) or severe anemia (52.0% [women] vs. 48.0% [men]) compared with normal hemoglobin (17.7% [women] vs. 82.3% [men]) (P<0.001). Patients with preoperative anemia were more likely to present with tissue loss (22.8% [normal] vs. 47.7% [moderate] vs. 52.0% [severe], P=0.01). Bypass target and conduit types were similar between groups. Anemic patients had longer median hospital length of stay compared with nonanemic patients (4days [normal] vs. 5days [mild] vs. 6days [moderate] vs. 7days [severe], P<0.001). Postoperative mortality at 30 days was similar across anemia groups (2.5% [normal] vs. 4.6% [moderate] vs. 8.0% [severe], P=0.23). On multivariable analysis, however, postoperative mortality was independently associated with severe anemia (odds ratio 7.5 [1.2-48.8], P=0.04) and male gender (odds ratio 7.5 [1.2-26.4], P=0.03). Preoperative anemia is common among patients undergoing infrainguinal bypass surgery and is an independent risk factor for postoperative mortality. Future investigation is needed to determine whether correction of anemia improves postoperative outcomes in these high-risk patients.

Impact of preoperative anemia, iron-deficiency and inflammation on survival after colorectal surgery-A retrospective cohort study.

BackgroundAnemia is present in up to two-thirds of patients undergoing colorectal surgery mainly caused by iron deficiency and inflammation. As anemia is associated with increased risk of perioperative death, diagnosis and treatment of preoperative anemia according to etiology have been recommended.ObjectiveThe aim of the present study was to assess if the association between anemia and survival in patients undergoing colorectal surgery was determined by the severity of anemia alone or also by anemia etiology.MethodsTo determine the prevalence of anemia and etiology, preoperative hematological parameters, C-reactive protein, ferritin and transferrin saturation were retrospectively assessed and correlated with outcome in a cohort of patients undergoing colorectal surgery between 2005 and 2019 at the University Hospital of Innsbruck. Anemia was defined as hemoglobin <120 g/L in females and <130 g/L in males. The etiology of anemia was classified on the basis of serum iron parameters, as iron deficiency anemia, anemia of inflammation or other anemia etiologies.ResultsPreoperative anemia was present in 54% (1316/2458) of all patients. Anemia was associated with iron deficiency in 45% (134/299) and classified as anemia of inflammation in 32% (97/299) of patients with available serum iron parameters. The etiology of anemia was a strong and independent predictor of survival, where iron deficiency and anemia of inflammation were associated with better postoperative survival than other anemia etiologies. One year survival rates were 84.3%, 77.3% and 69.1% for patients with iron deficiency anemia, anemia of inflammation and other anemia types. Inflammation indicated by high C-reactive protein is a strong negative predictor of overall survival.ConclusionsAnemia has a high prevalence among patients undergoing colorectal surgery and rational treatment requires early assessment of serum iron parameters and C-reactive protein.

Preoperative Anemia Is Not Associated With Major Perioperative Adverse Events but Increased Length of Postoperative Stay in Patients Undergoing Transcarotid Artery Revascularization

The impact of preoperative anemia in patients undergoing transcarotid artery revascularization (TCAR) is not well established. This study compared the perioperative outcomes of patients with and without preoperative anemia after TCAR.

Impact of preoperative anemia on surgeries for pelvic floor disorders

Impact of preoperative anemia on surgeries for pelvic floor disorders

Preoperative anaemia is an independent predictor of 30-day mortality post-CABG and improves de predictive accuracy of EuroScore II

Abstract Background The impact of preoperative anaemia on the results of cardiovascular surgery has already been demonstrated by some authors. Some of the studies observed worse surgical results in anaemic patients, however, in others, no difference was observed. In addition, the impact that the inclusion of anaemia or haemoglobin would have as a predictor in a risk model such as EuroScore II is not yet known. Purpose To evaluate the impact of preoperative anaemia on 30-day mortality post-CRM and compare the predictive accuracy of EuroScore II with and without the inclusion of haemoglobin levels in the model. Methods Single center cohort with 2168 patients consecutively included between January 2010 and December 2020. All procedures were performed with cardiopulmonary bypass. 32 baseline and operative characteristics were assessed. The primary outcomes were 30-day mortality and the EuroScore II predictive accuracy. Patients were stratified into two groups according to anaemia status. WHO Classification – haemoglobin: men &amp;lt;13 g/dL and women &amp;lt;12 g/dL. No Anaemia Group (1301–60.1%) – Anaemia Group (867–39,9%). Univariate analysis was performed to compare the characteristics of the groups, the occurrence of death in 30 days and to verify variables associated with mortality. Logistic regression analyses were used to assess predictors of mortality and generate a set of probabilities for assessing the predictive accuracy of EuroScore II with and without the addition of haemoglobin in the model. The probabilities generated through the regressions were analysed by ROC curves, which in turn were compared using the DeLong test. The level of significance was 5% and the statistical analysis was performed using Python 3.0. Results The anaemic patients were older and had higher prevalence of conditions, such as: diabetes, renal impairment, smoking, HF class III or IV, RBC transfusion and highest mean of EuroScore II (p&amp;lt;0.05 for all conditions). When comparing mortality in the groups, a significantly higher rate was observed in the anaemic group (2.2% vs 5.4%; p&amp;lt;0.001). In view of the heterogeneity of the groups, an adjusted logistic regression model was applied. The results of the multivariate model demonstrated that preoperative anaemia was an independent risk predictor for the occurrence of death in 30 days after CABG (B: 0.597; SE: 0.27; Wald: 5.2; OR: 1.82; 95% CI 1.09–3.04; p=0.022). In addition, we were able to verify that the addition of preoperative haemoglobin to EuroScore II resulted in a significantly higher predictive accuracy when compared to the predictive accuracy of the isolated score (AUCs: 0,732 vs 0.709; p=0.032). Conclusions Preoperative anaemia was an independent risk predictor for the occurrence of death in 30 days after CABG. We were also able to verify that the addition of the preoperative haemoglobin levels to EuroScore II resulted in a significantly higher predictive accuracy, improving the performance of the surgical risk model. Funding Acknowledgement Type of funding sources: None. Figure 1. Haemoglobin vs 30-day mortalityFigure 2. Predictive accuracies – EuroScore II

Impact of Preoperative Anemia in Patients Undergoing Peripheral Vascular Intervention

The Vascular Quality Initiative database was analyzed to determine whether preoperative anemia is associated with postoperative death, length of stay (LOS), and overall survival for patients undergoing peripheral vascular intervention (PVI). The national Vascular Quality Initiative database was queried for all PVIs performed between 2010 and 2019, and the outcomes were correlated with the presence of anemia. Anemia was classified as mild (10-13 g/dL for men and 10-12 g/dL for women), moderate (8-9.9 g/dL), and severe (<8 g/dL) using the World Health Organization definition of anemia. Analysis of variance or the Kruskal-Wallis test was used for continuous variables and the χ2 test for categorical variables. Multivariate logistic regression, generalized linear regression, and proportional Cox models were used to evaluate the association between preoperative anemia and postoperative 30-day mortality, total LOS, and overall survival time. A Kaplan-Meier curve was used to compare the survival time according to anemia severity. A total of 86,726 patients met the inclusion criteria. The demographics recorded included age (mean, 68 years), gender (59% male), and race (80% white). Anemia was documented in 41,627 patients (48%) and was mild in 29,687 (71%), moderate in 10,500 (25%), and severe in 1440 (4%). Demographics (age, gender, race) and comorbidities (smoking, body mass index, hypertension, chronic obstructive pulmonary disease, congestive heart failure, and a requirement for dialysis) were associated with the degree of preoperative anemia. The median follow-up was 4 years (range, 1.25-5.78 years). On univariate analysis, 30-day mortality, total LOS, and overall survival were significantly associated with the level of preoperative anemia (Table). These associations persisted in the multivariate models (Table). Kaplan-Meier survival was also associated with the degree of anemia (P < .001; Fig). The presence and degree of preoperative anemia was independently associated with 30-day mortality, total LOS, and overall survival for patients undergoing PVI. The presence and degree of anemia should be important components of preoperative risk stratification for patients undergoing PVI. Anemia should be a listed variable in all reports detailing the outcomes of PVI.TableUnivariate and multivariate analyses for overall survival, 30-day mortality, and total length of hospital stayPredictorUnivariateMultivariateHR95% CIP valueHR95% CIP valueOverall survival Normal hemoglobin1NANA1NANA Mild anemia2.232.16-2.31<.0011.501.44-1.57<.001 Moderate anemia3.533.39-3.67<.0012.021.91- 2.13<.001 Severe anemia3.503.21-3.82<.0012.141.76-2.24<.00130-Day mortalityOR95% CIP valueOR95% CIP value Normal hemoglobin1NANA1NA Mild anemia3.082.71-3.51<.0012.201.90-2.54<.001 Moderate anemia6.795.93-7.79<.0013.393.30-4.52<.001 Severe anemia8.206.41-10.38<.0013.943.11-5.35<.001Total LOSIRR95% CIP valueIRR95% CIP value Normal hemoglobin1NANA1NANA Mild anemia2.011.96-2.06<.0011.681.64-1.73<.001 Moderate anemia4.334.18-4.48<.0013.102.97-3.23<.001 Severe anemia5.975.48-6.51<.0014.984.50-5.54<.001CI, Confidence interval; HR, hazard ratio; IRR, incidence rate ratio; LOS, length of stay; NA, not applicable; OR, odds ratio.Boldface P values represent statistical significance. Open table in a new tab

The Impact of Preoperative Anaemia on Early Outcomes after Off-pump Coronary Artery Bypass Grafting

Introduction: In cardiac surgery, anaemia itself or combined with other risk factors has been found to be a major predictor for adverse outcome both preoperatively and postoperatively and even during extracorporeal circulation, but data about the specific tolerance of Coronary Artery Bypass Graft (CABG) patients for anaemia are conflicting and may in part be confounded by the effects of bypass surgery. Objectives: This study was performed in the National Institute of Cardiovascular Diseases (NICVD) to observe whether the early outcomes of Off-Pump CABG (OPCAB)were affected by pre-operative haematocrit levels. Methods: A total of 200 patients who underwent isolated OPCAB between January 2015 and December 2020 were retrospectively selected and purposively allocated into two groups: a)100 patients having preoperative anaemia and b) 100 patients without preoperative anaemia. Preoperative, per-operative and early post-operative variables were recorded, compiled and compared. Results: Preoperative characteristics were homogenously distributed between two groups other than haemoglobin level. Female patients had lower haemoglobin in each group. More patients of anaemic group required intraoperative and postoperative blood transfusion. The amount of blood loss and transfused blood products was also higher in anaemic patients. The ventilation time, length of ICU and post-operative hospital stay were significantly higher among anaemic patients. Among the post-operative complications, only the incidence of renal dysfunction was significantly higher among anaemic patients. Conclusion:This study has showed that anaemic patients undergoing OPCAB had an increased risk of postoperative adverse events. Importantly, the extent of preexisting comorbidities substantially affected perioperative anaemia tolerance. Therefore, preoperative risk assessment, optimization and subsequent therapeutic strategies, such as blood transfusion, should take into account both the individual level of preoperative haemoglobin and the extent of concomitant risk factors. Bangladesh Heart Journal 2021; 36(1) : 47-54

The impact of preoperative anemia on pancreatic resection outcomes

The impact of preoperative anemia on pancreatic resection outcomes

Impact of Preoperative Anemia on Outcomes of Enhanced Recovery Program After Colorectal Surgery: A Monocentric Retrospective Study.

Anemia is common before major abdominal surgery (35%). It is an independent factor for postoperative complications and longer length of stay (LOS). The aim of this study was to evaluate the extent to which preoperative anemia impacts on enhanced recovery programs (ERP) outcomes. The data for patients scheduled for colorectal surgery between 2015 and 2019, were analyzed (n = 494). All patients were managed with the same ERP. Demographic data, preoperative risk factors, postoperative complications, LOS and adherence to ERP were compared between anemic and non-anemic patients. Anemia was defined by a hemoglobin concentration < 13 g dL-1 in men and < 12 g dL-1 in women. In total, 173 patients had preoperative anemia. They were older (p < 0.001) and more often male (p = 0.02). The following risk factors were significantly more frequent in the anemic group: renal failure (p = 0.04), malnutrition (p < 0.001), cardiac arrhythmia (p < 0.001), coronaropathy (p = 0.02) and anticoagulant treatment (p < 0.001). Despite more risk factors, anemic patients did not experience more postoperative complications (38.2% vs. 31.2%, p = 0.12). Overall adherence to ERP was similar (18 [16-19] vs. 18 [17-19], p = 0.06). LOS was 4 [3-7] and 3 [2-6.25] days in the anemic and the non-anemic groups, respectively (p < 0.002). Multivariate analysis showed that anemia did not affect LOS (p = 0.27). Our study suggests that preoperative anemia does not detract from the benefits of ERP after elective colorectal surgery.

Preoperative anemia and complications after surgery for pelvic organ prolapse: an analysis of the national surgical quality improvement program database.

Preoperative anemia is a well-established risk factor for adverse perioperative outcomes in major surgery, but studies exploring complications after pelvic reconstructive surgery are limited. The objective of this study is to examine the impact of preoperative anemia on 30-day adverse outcomes in patients undergoing pelvic organ prolapse surgery. A retrospective cohort of women undergoing pelvic organ prolapse surgery was captured from the National Surgery Quality Improvement Program database (2014-2019). The primary outcome was a composite of postoperative medical complications such as pulmonary embolism, acute renal failure, stroke, myocardial infarction, cardiac arrest, deep vein thrombosis, and sepsis. Secondary outcomes included surgical site infection, bleeding requiring blood transfusion, readmission within 7days of surgery, and return to the operating room within 30days. Multivariate logistic regression was used to adjust for important pre-specified potential confounders. A total of 50,848 women were included in the analysis and 9.9% (4,579) met the criteria for anemia (hematocrit <36%). Potentially serious medical complications were rare, occurring in only 348 women (0.7%), and were more common among anemic patients (1.1% vs 0.6%, p < 0.001). On multivariate analysis, preoperative anemia was associated with higher odds of both potentially serious medical complications (OR 1.38, 95% CI 1.01-1.88) and returning to the operating room (OR 1.55, 95% CI 1.23-1.94). Anemic patients had a four-fold increase in the odds of requiring a blood transfusion (OR 4.47, 95% CI 3.60-5.56). Preoperative anemia is associated with an increased risk of adverse postoperative outcomes in women having surgery for pelvic organ prolapse.

The Impact of Preoperative Anemia on Complications After Total Shoulder Arthroplasty.

Background:This study investigated the relationship between varying levels of preoperative anemia and postoperative complications within 30 days of total shoulder arthroplasty (TSA).Methods:All patients who underwent TSA from 2015 to 2017 were queried from the American College of Surgeons National Surgical Quality Improvement database. Patients were categorized based on preoperative hematocrit levels: normal (>39% for men and >36% for women), mild anemia (29% to 39% for men and 29% to 36% for women), and severe anemia (<29% for both men and women).Results:A total of 10,547 patients were included in the study. Of these patients, 1,923 patients were (18.2%) in the mild anemia cohort and 146 (1.4%) were in the severe anemia cohort. Mild anemia was identified as a significant predictor of any complication (odds ratio [OR] 2.74, P < 0.001), stroke/cerebrovascular accident (OR 6.79, P = 0.007), postoperative anemia requiring transfusion (OR 6.58, P < 0.001), nonhome discharge (OR 1.79, P < 0.001), readmission (OR 1.63, P < 0.001), and return to the surgical room (OR 1.60, P = 0.017). Severe anemia was identified as a significant predictor of any complication (OR 4.31, P < 0.001), renal complication (OR 13.78, P < 0.001), postoperative anemia requiring transfusion (OR 5.62, P < 0.001), and nonhome discharge (OR 2.34, P < 0.001).Conclusion:Preoperative anemia status is a risk factor for complications within 30 days of TSA.

Impact of Preoperative Anemia on Outcomes After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis

The aim of this study was to investigate the relationship of preoperative anemia and outcomes after posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS). A retrospective cohort study was performed using the American College of Surgeons National Surgical Quality Improvement Program-Pediatric database from 2016 to 2018. All pediatric patients (age 10-18 years) with AIS undergoing PSF were identified. Two cohorts were categorized into anemic and nonanemic cohorts based on age-based and sex-based criteria for anemia. Thirty-day outcomes and readmission rates were evaluated. A total of 4929 patients were identified, of whom 592 (12.0%) were found to have preoperative anemia. The anemic cohort had a greater prevalence of comorbidities and longer operative times. Compared with the nonanemic cohort, the anemic cohort experienced significantly higher rates of perioperative bleed/transfusion (nonanemic, 67.4% vs. anemic, 73.5%; P= 0.004) and required a greater total amount of blood transfused (nonanemic, 283.2 ± 265.5 mL vs. anemic, 386.7 ± 342.6 mL; P < 0.001). The anemic cohort experienced significantly longer hospital stays (nonanemic, 3.8 ± 2.2 days vs. anemic, 4.2 ± 3.9 days; P= 0.001), yet discharge disposition (P= 0.58), 30-day complication rates (P= 0.79) and unplanned reoperation rates (P= 0.90) were similar between cohorts. On multivariate analysis, anemia was found to be an independent predictor of perioperative bleed/transfusion (odds ratio, 1.36; 95% confidence interval, 1.12-1.66; P= 0.002) as well as a longer length of hospital stay (relative risk, 0.46; 95% confidence interval, 0.25-0.67; P < 0.001) but was not an independent predictor for postoperative complications (P= 0.85). Our study suggests that preoperative anemia may be a risk factor for a greater perioperative bleed/transfusion event and slightly longer length of stay; however, it was not associated with greater 30-day complication and readmission rates in patients with AIS undergoing PSF.

Impact of Preoperative Anemia on Short-Term Surgical Outcomes in Patients Undergoing Colectomy for Colon Cancer

Impact of Preoperative Anemia on Short-Term Surgical Outcomes in Patients Undergoing Colectomy for Colon Cancer