Why the study?
Does preprocedural hemoglobin level predict 9-month all-cause mortality in patients undergoing peripheral vascular interventions?
Does preprocedural hemoglobin level predict 9-month all-cause mortality in patients undergoing peripheral vascular interventions?
Preprocedural hemoglobin level is a significant independent predictor of 9-month mortality in patients undergoing peripheral vascular interventions, with the highest risk observed in patients with levels ≤ 10 g/dl.
May support hemoglobin-based risk stratification in peripheral interventions; leaves open whether correction alters outcomes.
BACKGROUND: Serum hemoglobin (H) level is a well-known predictor of all-cause mortality in patients undergoing percutaneous coronary interventions but has not been studied in patients undergoing peripheral vascular interventions (PVI). We sought to determine the prognostic significance of serum H in patients undergoing PVI. METHODS: We identified 346 consecutive patients undergoing PVI who had a documented a baseline and a postprocedural serum H level over a 33-month period. A multivariate analysis of predictors of 9-month mortality was performed. RESULTS: Of 346 patients identified, there were 28 deaths (8.1%) over a 9-month follow-up period. Periprocedural H change was not associated with death [OR: 1.12 (95% CI: 0.71-1.79), P = NS]. In a multivariate model independent predictors of all-cause mortality were clinical bleeding [OR: 10.7 (95% CI: 0.012-0.769), P = 0.026], emergency intervention [OR: 4.5 (95% CI: 0.07-0.71), P = 0.011], ejection fraction [OR: 1.02 (95% CI: 1.01-1.05), P = 0.020], and preprocedural H [OR: 1.56 (95% CI: 1.19-2.04) P = 0.001]. CONCLUSION: In patients undergoing PVI, preprocedural H was a significant predictor of 9-month all-cause mortality. The highest mortality rate was seen in patients with a preprocedural H level ≤ 10 g/dl. Preprocedural H level can be used in clinical practice to risk stratify patients being considered for PVI. Further investigation is needed to assess if optimization of H level preprocedure improves midterm mortality.
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Jaffery et al. (2011) studied this question.
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