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Date Published: 10/03/2010
ITO Focus
Preoperative anemia in elective cardiac surgery: prevalence, risk
factors, and influence on postoperative outcome
Cardiac surgery is often associated with important blood loss resulting in a need for perioperative allogeneic blood transfusion (ABT). ABT can increase the risk of postoperative complications, including an increased risk in mortality.
Preoperative hemoglobin levels can be used to predict the risk of ABT. Preoperative anemia, however, is not only a useful indicator of the risk of ABT, but also of postoperative complications and lower survival rates in patients undergoing coronary bypass surgery. Preoperative anemia is one of the preoperative risk factors for ABT that can be modified. Researchers from Spain, led by Professor Manuel Munoz from the University of Malaga, sought to determine the prevalence and risks for preoperative anemia and the influence of the latter on ABT and postoperative outcomes in patients undergoing cardiac surgery.
Munoz et al. conducted a retrospective observational single-center study (n=576) and found a high prevalence of preoperative anemia (36.5%), and confirmed their hypothesis of the clinical importance of preoperative anemia: anemia was associated with increased allogeneic blood transfusion requirements and postoperative morbidity. The independent risk factors for preoperative anemia are: age, chronic kidney disease and drug intake (proton pump inhibitors, diuretics, ACE inhibitors).
The authors recommend early recognition of anemia and timely treatment based on pathophysiological considerations.
References
Muñoz M, Ariza D, Gómez-Ramírez S, et al.
Preoperative anemia in elective cardiac surgery: prevalence, risk factors, and influence on postoperative outcome.
Transfus Alternat Transfus Med 2010;11(2):47-56.
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