Borderline anaemia and postoperative outcome in women undergoing major abdominal surgery: a retrospective cohort study

Anaesthesia - Tập 75 Số 2 - Trang 210-217 - 2020
Lachlan F. Miles1, Thomas Larsen2, Michael Bailey3, Kate L. Burbury4, David Story1, Rinaldo Bellomo1
1Centre for Integrated Critical Care, Melbourne Medical School, Vic., Australia
2Data Analytics Research and Evaluation (DARE) Centre, Austin Health, Melbourne, Vic., Australia
3Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia.
4Sir Peter MacCallum Department of Oncology, The University of Melbourne, VIC, Australia

Tóm tắt

Summary

Pre‐operative anaemia is typically diagnosed with a haemoglobin concentration < 120 g.l−1 for women and < 130 g.l−1 for men on the basis of limited evidence. This retrospective cohort study stratified women undergoing elective, major abdominal surgery based on pre‐operative haemoglobin concentration: anaemic (< 120 g.l−1); borderline anaemic (120–129 g.l−1); and non‐anaemic (> 130 g.l−1). Data from 1554 women were analysed. Women with borderline anaemia had a greater incidence of postoperative complications (55 (16%) vs. 110 (11%); p = 0.026), longer duration of hospital stay (median (IQR [range]) 3 (1–6 [0–69]) days vs. 2 (1–5 [0–80]) days; p = 0.017) and fewer days alive and out of hospital at postoperative day 30 (median (IQR [range]) 27 (23–29 [0–30]) vs. 28 (25–29 [0–30]) days; p = 0.017) compared with non‐anaemic women. However, after matched cohort analysis, these outcome differences no longer remained statistically significant. After multivariable adjustment for procedure, Charlson comorbidity index and patient age, a negative relationship between logarithmic pre‐operative haemoglobin concentration and duration of stay was found (parameter estimate (standard error) −0.006 (0.003) vs. 0.003 (0.003) for a haemoglobin concentration < 130 g.l−1 vs. > 130 g.l−1, respectively; p = 0.03); the difference in duration of stay was approximately 50% greater for women with a haemoglobin concentration of 120 g.l−1 compared with those with a haemoglobin concentration of 130 g.l−1. Although the contribution of borderline anaemia to the incidence of postoperative complications is uncertain, the current diagnostic criteria should be re‐assessed.

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Anaesthesia

Tập 75 Số 2

210-217

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