Preoperative anemia in adults undergoing video-assisted thoracoscopic surgery was associated with increased 30-day mortality compared to normal hemoglobin (OR 3.20; 95% CI 2.33-4.39; P<0.0001).
Cohort (n=16,692)
Yes
Does preoperative anemia increase the risk of adverse outcomes in adults undergoing video-assisted thoracoscopic surgery?
Preoperative anemia is associated with an over threefold increased risk of 30-day mortality and higher rates of complications following video-assisted thoracoscopic surgery.
Odds Ratio: 3.2 (95% CI 2.33–4.39)
p-value: p=<0.0001
BACKGROUND: Video-assisted thoracoscopic surgery (VATS) involves unique physiological challenges, including single-lung ventilation, that may amplify the effects of reduced oxygen-carrying capacity in anemic patients. Despite the minimally invasive nature of VATS, the specific impact of preoperative anemia on outcomes following these procedures remains inadequately characterized. METHODS: We conducted a multi-institutional retrospective cohort study using TriNetX research network data (2010-2024). Adults undergoing VATS with preoperative hemoglobin measurements were included. The anemia group (hemoglobin 8-12 g/dL) was compared to the control group (hemoglobin ≥12 g/dL) using 1:1 propensity score matching. RESULTS: After matching, 8,346 pairs of patients were analyzed. Patients with preoperative anemia had significantly higher 30-day mortality (odds ratio OR 3.20, 95% confidence interval CI 2.33-4.39, P<0.0001) (primary outcome), intensive care unit admission (OR 1.46, 95% CI 1.27-1.67, P<0.0001), acute kidney injury (AKI) (OR 1.92, 95% CI 1.58-2.32, P<0.0001), pneumonia/respiratory failure (OR 1.73, 95% CI 1.53-1.95, P<0.0001), and sepsis (OR 1.79, 95% CI 1.36-2.36, P<0.0001). These associations remained consistent in sensitivity analyses restricted to academic medical centers, patients without blood transfusions, and those with stable hemoglobin levels throughout the perioperative period. Sex-specific analyses revealed higher risks of respiratory complications, AKI, sepsis, and deep vein thrombosis in males, while females with anemia demonstrated higher mortality risk. Even mild anemia was associated with significantly increased complications. CONCLUSIONS: Preoperative anemia is strongly associated with adverse outcomes following VATS, with an over threefold increased mortality risk. These findings highlight the importance of preoperative anemia assessment and management in patients undergoing VATS.
HUNG et al. (Thu,) conducted a cohort in Video-assisted thoracoscopic surgery (VATS) (n=16,692). Preoperative anemia (hemoglobin 8-12 g/dL) vs. Hemoglobin ≥12 g/dL was evaluated on 30-day mortality (OR 3.20, 95% CI 2.33-4.39, p=<0.0001). Preoperative anemia in adults undergoing video-assisted thoracoscopic surgery was associated with increased 30-day mortality compared to normal hemoglobin (OR 3.20; 95% CI 2.33-4.39; P<0.0001).
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