Preoperative anemia (severe, moderate, and mild) independently increased the risk of a 30-day adverse composite outcome compared to no anemia (ORs 1.83, 2.19, and 1.49, respectively).
Cohort (n=23,348)
Yes
Does preoperative anemia increase adverse postoperative outcomes in patients undergoing elective open and laparoscopic colectomies?
Preoperative anemia of any severity is an independent risk factor for 30-day complications and prolonged hospital stay following elective colectomy.
Effect estimate: OR 1.83 (95% CI 1.05-3.19)
BACKGROUND: Complications associated with blood transfusions have resulted in widespread acceptance of low hematocrit levels in surgical patients. However, preoperative anemia seems to be a risk factor for adverse postoperative outcomes in certain surgical patients. This study investigated the National Surgical Quality Improvement Program (NSQIP) database to determine if preoperative anemia in patients undergoing open and laparoscopic colectomies is an independent predictor for an adverse composite outcome (CO) consisting of myocardial infarction, stroke, progressive renal insufficiency or death within 30 days of operation, or for an increased hospital length of stay (LOS). STUDY DESIGN: Hematocrit levels were categorized into 4 classes: severe, moderate, mild, and no anemia. From 2005 to 2008, the NSQIP database recorded 23,348 elective open and laparoscopic colectomies that met inclusion criteria. Analyses using multivariable models, controlling for potential confounders and stratifying on propensity score, were performed. RESULTS: Compared with nonanemic patients, those with severe, moderate, and mild anemia were more likely to have the adverse CO with odds ratios of 1.83 (95% CI 1.05 to 3.19), 2.19 (95 % CI 1.63 to 2.94), and 1.49 (95% CI 1.20 to 1.86), respectively. Patients with a normal hematocrit had a reduced hospital LOS, compared with those with severe, moderate, and mild anemia (p < 0.01). A history of cardiovascular disease did not significantly influence these findings. CONCLUSIONS: This large multicenter database analysis suggests that the presence of severe and moderate and even mild preoperative anemia is an independent risk factor for complications and a longer hospital stay after colon surgery.
Leichtle et al. (Thu,) conducted a cohort in Elective open and laparoscopic colectomies (n=23,348). Preoperative anemia vs. No anemia was evaluated on Composite outcome of myocardial infarction, stroke, progressive renal insufficiency or death within 30 days of operation (OR 1.83, 95% CI 1.05-3.19). Preoperative anemia (severe, moderate, and mild) independently increased the risk of a 30-day adverse composite outcome compared to no anemia (ORs 1.83, 2.19, and 1.49, respectively).