The Association of Preoperative Hematocrit and Transfusion with Mortality in Patients Undergoing Elective Non-cardiac Surgery

The Association of Preoperative Hematocrit and Transfusion with Mortality in Patients Undergoing... Background Patients with anemia frequently undergo surgery, as it is unclear at what threshold clinicians should consider delaying surgery for preoperative anemia optimization. The primary objective of this study was to determine whether there is an association of varying degrees of anemia and transfusion with 30-day mortality. Methods This is a retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program database from 2011 to 2013. Cohorts were analyzed based on preoperative hematocrit range— patients with: (1) no anemia, (2) hematocrit C33% and \36% in females or \39% in males, (3) hematocrit C30% and \33%, (4) hematocrit C27% and \30%, (5) hematocrit C24% and \27%, and (6) hematocrit C21% and less than 24%. Multivariable logistic regression was used to analyze the association of anemia and transfusion with 30-day in-hospital mortality. Results The odds for 30-day mortality increased incrementally as the hematocrit ranges decreased, in which pre- operative hematocrit between 21 and 24% had the highest odds for this outcome (odds ratio [OR] 6.50, p\ 0.0001) compared to the reference group (no anemia). The use of transfusion increased the odds of mortality even further (OR 5.57, p\ 0.0001). Among patients that received an intra-/postoperative transfusion, preoperative http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png World Journal of Surgery Springer Journals

The Association of Preoperative Hematocrit and Transfusion with Mortality in Patients Undergoing Elective Non-cardiac Surgery

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Publisher
Springer Journals
Copyright
Copyright © 2017 by Société Internationale de Chirurgie
Subject
Medicine & Public Health; Surgery; Abdominal Surgery; Cardiac Surgery; General Surgery; Thoracic Surgery; Vascular Surgery
ISSN
0364-2313
eISSN
1432-2323
D.O.I.
10.1007/s00268-017-4359-y
Publisher site
See Article on Publisher Site

Abstract

Background Patients with anemia frequently undergo surgery, as it is unclear at what threshold clinicians should consider delaying surgery for preoperative anemia optimization. The primary objective of this study was to determine whether there is an association of varying degrees of anemia and transfusion with 30-day mortality. Methods This is a retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program database from 2011 to 2013. Cohorts were analyzed based on preoperative hematocrit range— patients with: (1) no anemia, (2) hematocrit C33% and \36% in females or \39% in males, (3) hematocrit C30% and \33%, (4) hematocrit C27% and \30%, (5) hematocrit C24% and \27%, and (6) hematocrit C21% and less than 24%. Multivariable logistic regression was used to analyze the association of anemia and transfusion with 30-day in-hospital mortality. Results The odds for 30-day mortality increased incrementally as the hematocrit ranges decreased, in which pre- operative hematocrit between 21 and 24% had the highest odds for this outcome (odds ratio [OR] 6.50, p\ 0.0001) compared to the reference group (no anemia). The use of transfusion increased the odds of mortality even further (OR 5.57, p\ 0.0001). Among patients that received an intra-/postoperative transfusion, preoperative

Journal

World Journal of SurgerySpringer Journals

Published: Nov 15, 2017

References

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