MiscellaneousAnemia as an Independent Predictor of Perioperative and Long-Term Cardiovascular Outcome in Patients Scheduled for Elective Vascular Surgery
Section snippets
Methods
In a retrospective study, a series of 1,363 patients scheduled for elective noncardiac open vascular surgery with known or suspected coronary artery disease who were referred for preoperative testing from February 1990 to August 2006 to the Erasmus Medical Centre, Rotterdam, The Netherlands, were analyzed. Preoperative testing included laboratory measurement, echocardiography, and assessment of baseline characteristics. A total of 152 patients were treated at another hospital and were excluded
Results
Of the 1,211 patients included in the study, 877 were men (77%) and mean age was 68 ± 11 years. At baseline, anemia was present in 399 patients (33%), of which tertiles were calculated, resulting in 133 patients with mild anemia, 133 with moderate anemia, and 133 with severe anemia. Mean hemoglobin levels were 14.5 ± 1.1 g/dl in nonanemic patients, 12.4 ± 0.5 g/dl in patients with mild anemia, 11.3 ± 0.5 g/dl in patients with moderate anemia, and 9.8 ± 0.8 g/dl in patients with severe anemia.
Discussion
This study showed that extent of preoperative anemia and worsening renal function were strong predictors of perioperative and long-term MACEs, even after adjusting for known confounders. The association was graded, with increasing severity of anemia and renal dysfunction correlating with an increasing risk for MACEs. At 30 days postoperatively, only moderate and severe anemias were significantly associated with increased risk of MACEs. However, this could be due to the power of the study
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2019, Journal of Vascular SurgeryCitation Excerpt :Moreover, anemia is a common and inter-related finding in CHF and CKD. Thus, it is unknown whether anemia is an independent predictor for poor cardiac outcome or whether it is secondary to other underlying comorbidities20 (Fig 4). Our hypothesis was that anemia is not only a marker of other comorbidities that increase the risk of perioperative cardiac events but also an independent and modifiable clinical marker.
Dr. Dunkelgrun is supported by an unrestricted research grant (Grant 2003B143) from the Netherlands Heart Foundation, The Hague, The Netherlands. Dr. Schouten is supported by an unrestricted research grant from the Netherlands Organization of Health Research and Development (ZonMW), The Hague, The Netherlands. Dr. Hoeks and Dr. Vidakovic are supported by an unrestricted research grant from the Lijf & Leven Foundation, Rotterdam, The Netherlands.