Pre-operative anaemia and myocardial injury after noncardiac surgery: A retrospective study.
Eur J Anaesthesiol
; 38(6): 582-590, 2021 06 01.
Article
en En
| MEDLINE
| ID: mdl-33399380
ABSTRACT
BACKGROUND:
Pre-operative anaemia is associated with adverse outcomes of noncardiac surgery, but its association with myocardial injury after noncardiac surgery (MINS) has not been fully investigated.OBJECTIVE:
The association between pre-operative anaemia and MINS.DESIGN:
A single-centre retrospective cohort study.SETTING:
Tertiary care referral centre. PATIENTS Patients with measured cardiac troponin (cTn) I levels after noncardiac surgery.INTERVENTIONS:
Patients were separated according to pre-operative anaemia (haemoglobin <13âgâdl-1 in men and <12âgâdl-1 in women). Anaemia was further stratified into mild and moderate-to-severe at a haemoglobin level threshold of 11âgâdl-1. MAIN OUTCOMEMEASURES:
The primary outcome was MINS, defined as a peak cTn I level more than 99th percentile of the upper reference limit within 30 postoperative days.RESULTS:
Data from a total of 35 170 patients were collected, including 22â062 (62.7%) patients in the normal group and 13â108 (37.3%) in the anaemia group. After propensity score matching, 11919 sets of patients were generated, and the incidence of MINS was significantly associated with anaemia [14.5 vs. 21.0%, odds ratio (OR) 1.57, 95% confidence interval (CI) 1.47 to 1.68, Pâ<â0.001]. For the entire population, multivariable analysis showed a graded association between anaemia severity and MINS (OR 1.32, 95% CI 1.22 to 1.43, Pâ<â0.001 for mild anaemia and OR 1.80, 95% CI 1.66 to 1.94, Pâ<â0.001 for moderate-to-severe anaemia compared with the normal group) and a significantly higher incidence of MINS for moderate-to-severe anaemia than mild anaemia (18.6 vs. 28.6%, OR 1.37, 95% CI 1.25 to 1.50, Pâ<â0.001). The estimated threshold for pre-operative haemoglobin associated with MINS was 12.2âgâdl-1, with an area under the curve of 0.622.CONCLUSIONS:
Pre-operative anaemia was independently associated with MINS, suggesting that MINS may be related to the association between anaemia and postoperative mortality. TRIAL REGISTRATION SMC 2019-08-048.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
/
Anemia
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Female
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Humans
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Male
Idioma:
En
Revista:
Eur J Anaesthesiol
Asunto de la revista:
ANESTESIOLOGIA
Año:
2021
Tipo del documento:
Article