Severe Anemia Linked to Poorer Heart Surgery Outcomes

Higher risk of stroke, major morbidity, operative mortality with severe, moderate pre-op anemia

WEDNESDAY, Oct. 3 (HealthDay News) -- Adults undergoing cardiac surgery who have moderate-to-severe preoperative anemia have significantly increased morbidity and mortality compared with non-severely anemic patients, according to research published in the October issue of the Annals of Thoracic Surgery.

Marco Ranucci, M.D., of the Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Donato in Milan, and colleagues conducted a retrospective study to examine postoperative outcomes for 401 adult patients with severe preoperative anemia (hematocrit <30 percent) who underwent cardiac surgery. Postoperative morbidity and mortality were compared with those of a control group of 401 propensity matched non-severely anemic patients.

The researchers found that preoperative comorbidities and operative details were comparable between the groups. For patients with severe preoperative anemia, there was a significantly higher rate of stroke (1 versus 0 percent; P = 0.045), major morbidity (27.4 versus 17.5 percent; P = 0.001), and operative mortality (12.7 versus 7.5 percent; P = 0.014). These results were confirmed on additional analysis which included patients with moderate preoperative anemia.

"Moderate-to-severe preoperative anemia is a risk factor for major morbidity and operative mortality in adult cardiac operations," the authors write. "This finding is confirmative of the role of preoperative anemia in determining adverse events in major non-cardiac operations."

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