Pre-Op Anemia Ups Mortality After Non-Cardiac Surgery

Even mild preoperative anemia independently associated with 30-day mortality, morbidity risk

THURSDAY, Oct. 6 (HealthDay News) -- For patients undergoing non-cardiac surgery, even a mild degree of preoperative anemia is independently associated with an increased risk of 30-day morbidity and mortality, according to a study published online Oct. 6 in The Lancet.

Khaled M. Musallam, M.D., from the American University of Beirut Medical Center in Lebanon, and colleagues investigated the effect of preoperative anemia on 30-day postoperative morbidity and mortality in 69,229 patients with preoperative anemia who underwent major non-cardiac surgery in 2008. Data were collected for 30-day mortality, morbidity, demographics, and preoperative and perioperative risk factors. The effect of mild (defined as hematocrit concentration of >29 to <39 percent in men and >29 to <36 percent in women) and moderate-to-severe (defined as hematocrit concentration of ≤29 percent in men and women) on postoperative outcomes was assessed in adjusted and modified (including nine predefined risk factor subgroups) analyses.

The investigators found that, after adjustment, patients with anemia had higher postoperative 30-day mortality and composite postoperative 30-day morbidity than those without anemia (odds ratio [OR], 1.42 and 1.35, respectively). This difference was consistent in mild anemia (OR, 1.41 and 1.31, respectively) and in moderate-to-severe anemia (OR, 1.44 and 1.56, respectively). Patients with anemia and most risk factors had an increased adjusted OR for 30-day mortality and morbidity than patients with either anemia or the risk factor alone, compared to patients without anemia or a defined risk factor.

"Preoperative anemia, 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," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry, including Vifor Pharma, which funded the study.

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