Impact of anemia on outcomes in on-pump coronary artery bypass surgery patients

Kardiologiia ◽  
2021 ◽  
Vol 61 (11) ◽  
pp. 42-48
Author(s):  
A. A. Kupryashov ◽  
E. V. Kuksina ◽  
G. A. Kchycheva ◽  
G. A. Haydarov

Aim    To study the contribution of preoperative anemia to the prognosis of adverse clinical events (mortality, complications, transfusion) in patients with ischemic heart disease (IHD) after myocardial revascularization in the conditions of artificial circulation.Material and methods    This retrospective cohort study included 1 133 patients with IHD who had undergone isolated myocardial revascularization in the conditions of artificial circulation in 2019. The primary endpoints were mortality and a composite endpoint that included, in addition to mortality, cases of acute coronary syndrome, heart, respiratory and renal failure, neurological deficit, and infectious complications. The secondary endpoints were duration of artificial ventilation of more than 12 h, duration of stay in the resuscitation and intensive care unit (RICU) of more than one day, and duration of postoperative inpatient treatment of more than 7 days. Results    Preoperative anemia was found in 196 (17.3 %) patients. The anemia was not associated with mortality but increased the risk of the composite endpoint, prolonged artificial ventilation, stay in RICU for more than one day, and red blood cell transfusion. Despite the absence of a relationship between red blood cell transfusion and mortality, the use of transfusion was associated with increased risks of the composite endpoint and prolonged stay in the RICU and hospital.Conclusion    Preoperative anemia is a risk factor for adverse outcomes of myocardial revascularization in the conditions of artificial circulation. Timely treatment of preoperative anemia may improve outcomes of the treatment. 

2016 ◽  
Vol 13 (2) ◽  
pp. 231-241 ◽  
Author(s):  
Yushu Wang ◽  
Xiuli Shi ◽  
Rongsheng Du ◽  
Yucheng Chen ◽  
Qing Zhang

2020 ◽  
Vol 46 (2) ◽  
Author(s):  
Oliver Poole ◽  
André Bernard ◽  
Blaine Kent ◽  
Paul Brousseau

Rationale: Lower extremity joint arthroplasty can lead to significant blood loss, and the need for blood transfusion. The use of blood products is associated with a variety of adverse outcomes including infection, circulatory overload, and transfusion reaction. Objectives: The objective of this quality improvement study is to identify the prevalence of preoperative anemia at our institution, and elucidate its impact on perioperative transfusion in elective patients undergoing primary or revision hip arthroplasty. Methods: Data for this study was collected from four databases at our institution. Elective patients undergoing primary or revision hip arthroplasty were selected. Transfusion was defined as the receipt of a red blood cell transfusion on the surgical day through to postoperative day five. The primary outcome was the effect of preoperative anemia on transfusion rates. Results: The overall transfusion rate was 7.6%. Transfusion rates for primary and revision arthroplasty were 5.8% and 18.7% respectively. Patients with a preoperative hemoglobin between 100 and 120 g/L were 4.5 times more likely to be transfused than those with a hemoglobin between 121 and 140 g/L, and 15.4 times more likely than those greater than 140 g/L. Preoperative anemia was common, with 11.5% of all patients having a preoperative hemoglobin of 120 g/L or less. Conclusion: Preoperative anemia was common and was significantly associated with higher transfusion rates. These findings reinforce the need to optimize hip arthroplasty patients prior to surgery, where possible. As a quality control study, these findings may help direct policy regarding the deferral of elective hip arthroplasty patients who are anemic preoperatively.


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