Preoperative anaemia and outcome after elective cardiac surgery: a Dutch national registry analysis.

Autor:	Hazen YJJM; Department of Anaesthesiology, Intensive Care and Pain Medicine, Amphia Hospital, Breda, The Netherlands., Noordzij PG; Department of Anaesthesiology, Intensive Care and Pain Medicine, St Antonius Hospital, Nieuwegein, The Netherlands., Gerritse BM; Department of Anaesthesiology, Intensive Care and Pain Medicine, Amphia Hospital, Breda, The Netherlands., Scohy TV; Department of Anaesthesiology, Intensive Care and Pain Medicine, Amphia Hospital, Breda, The Netherlands., Houterman S; Netherlands Heart Registration, Utrecht, The Netherlands., Bramer S; Department of Cardiothoracic Surgery, Amphia Hospital, Breda, The Netherlands., Berendsen RR; Department of Anaesthesiology, Leiden University Medical Centre, Leiden, The Netherlands., Bouwman RA; Department of Anaesthesiology, Catharina Hospital, Eindhoven, The Netherlands., Eberl S; Department of Anaesthesiology, Academic Medical Centre, Amsterdam, The Netherlands., Haenen JSE; Department of Anaesthesiology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands., Hofland J; Department of Anaesthesiology, Radboud University Medical Centre, Nijmegen, The Netherlands., Ter Horst M; Department of Anaesthesiology, Erasmus Medical Centre, Rotterdam, The Netherlands., Kingma MF; Department of Anaesthesiology, Haga Hospital, The Hague, The Netherlands., Van Klarenbosch J; Department of Anaesthesiology, University Medical Centre Utrecht, Utrecht, The Netherlands., Klok T; Department of Anaesthesiology, OLVG, Amsterdam, The Netherlands., De Korte MPJ; Department of Anaesthesiology, Maastricht University Medical Centre, Maastricht, The Netherlands., Van Der Maaten JMAA; Department of Anaesthesiology, University Medical Centre Groningen, Groningen, The Netherlands., Spanjersberg AJ; Department of Anaesthesiology, Isala Clinic Zwolle, Zwolle, The Netherlands., Wietsma NE; Department of Anaesthesiology, Medical Spectrum Twente, Enschede, The Netherlands., van der Meer NJM; Executive Board of Directors, Catharina Hospital, Eindhoven, The Netherlands., Rettig TCD; Department of Anaesthesiology, Intensive Care and Pain Medicine, Amphia Hospital, Breda, The Netherlands. Electronic address: trettig@amphia.nl.
Jazyk:	angličtina
Zdroj:	British journal of anaesthesia [Br J Anaesth] 2022 Apr; Vol. 128 (4), pp. 636-643. Date of Electronic Publication: 2022 Jan 12.
DOI:	10.1016/j.bja.2021.12.016
Abstrakt:	Background: Previous studies have shown that preoperative anaemia in patients undergoing cardiac surgery is associated with adverse outcomes. However, most of these studies were retrospective, had a relatively small sample size, and were from a single centre. The aim of this study was to analyse the relationship between the severity of preoperative anaemia and short- and long-term mortality and morbidity in a large multicentre national cohort of patients undergoing cardiac surgery. Methods: A nationwide, prospective, multicentre registry (Netherlands Heart Registration) of patients undergoing elective cardiac surgery between January 2013 and January 2019 was used for this observational study. Anaemia was defined according to the WHO criteria, and the main study endpoint was 120-day mortality. The association was investigated using multivariable logistic regression analysis. Results: In total, 35 484 patients were studied, of whom 6802 (19.2%) were anaemic. Preoperative anaemia was associated with an increased risk of 120-day mortality (adjusted odds ratio [aOR] 1.7; 95% confidence interval [CI]: 1.4-1.9; P<0.001). The risk of 120-day mortality increased with anaemia severity (mild anaemia aOR 1.6; 95% CI: 1.3-1.9; P<0.001; and moderate-to-severe anaemia aOR 1.8; 95% CI: 1.4-2.4; P<0.001). Preoperative anaemia was associated with red blood cell transfusion and postoperative morbidity, the causes of which included renal failure, pneumonia, and myocardial infarction. Conclusions: Preoperative anaemia was associated with mortality and morbidity after cardiac surgery. The risk of adverse outcomes increased with anaemia severity. Preoperative anaemia is a potential target for treatment to improve postoperative outcomes. Competing Interests: Declarations of interest The authors declare that they have no conflicts of interest. (Copyright © 2021 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu