Anaemia in patients who underwent vascular surgery: a significant predictor of amputation and death.
Anemia en pacientes sometidos a cirugía vascular, factor predictor de amputación y muerte.
Adult
Age Factors
Aged
Aged, 80 and over
Amputation, Surgical
/ statistics & numerical data
Anemia
/ blood
Aneurysm
/ blood
Cardiovascular Diseases
/ blood
Cause of Death
Female
Hemoglobin A
/ analysis
Humans
Ischemia
/ blood
Kaplan-Meier Estimate
Logistic Models
Male
Middle Aged
Peripheral Vascular Diseases
/ blood
Postoperative Complications
/ blood
Prevalence
Prognosis
ROC Curve
Retrospective Studies
Risk Factors
Survival Analysis
Vascular Surgical Procedures
/ adverse effects
Anaemia
Anemia
Enfermedad arterial periférica
Peripheral arterial disease
Journal
Medicina clinica
ISSN: 1578-8989
Titre abrégé: Med Clin (Barc)
Pays: Spain
ID NLM: 0376377
Informations de publication
Date de publication:
04 01 2019
04 01 2019
Historique:
received:
11
10
2017
revised:
04
01
2018
accepted:
11
01
2018
pubmed:
14
4
2018
medline:
28
2
2020
entrez:
14
4
2018
Statut:
ppublish
Résumé
In patients with peripheral artery disease requiring surgery, anaemia has been found to independently predict short and medium term higher morbidity and mortality. We retrospectively studied all patients undergoing surgery, consecutively during 2months in 12 vascular surgery units. We analysed cardiovascular risk factors and preoperative haemoglobin. Statistical analysis was done with Kaplan-Meier for survival and logistic regression modelling to identify predictors of mortality. 518 patients were consecutively operated on in our vascular units, the mortality rate was 21% the first year and 34% for cardiovascular events. Preoperative anaemia was present in 63% of the ischemic patients and in 23% of the patients requiring aneurysm repair, one year after surgery it increased to 68% and 50% respectively. When preoperative anaemia was superior to 10mg/dl, one year survival increased (96% vs. 90%), fewer cardiovascular events occurred and there were fewer amputations (24% vs. 68%). On multivariable analysis: age, renal failure, chronic lung disease, coronary artery disease, postoperative complications and previous cardiovascular events were associated with an increased risk mortality rate. Preoperative haemoglobin influenced proportionally such that for every 1mg /dl increase, the probability of mortality decreases by 0.81. Preoperative anaemia, especially when haemoglobin is inferior to 10mg/dl, is associated with an increased risk of death and amputation.
Sections du résumé
BACKGROUND AND OBJECTIVE
In patients with peripheral artery disease requiring surgery, anaemia has been found to independently predict short and medium term higher morbidity and mortality.
PATIENTS AND METHODS
We retrospectively studied all patients undergoing surgery, consecutively during 2months in 12 vascular surgery units. We analysed cardiovascular risk factors and preoperative haemoglobin. Statistical analysis was done with Kaplan-Meier for survival and logistic regression modelling to identify predictors of mortality.
RESULTS
518 patients were consecutively operated on in our vascular units, the mortality rate was 21% the first year and 34% for cardiovascular events. Preoperative anaemia was present in 63% of the ischemic patients and in 23% of the patients requiring aneurysm repair, one year after surgery it increased to 68% and 50% respectively. When preoperative anaemia was superior to 10mg/dl, one year survival increased (96% vs. 90%), fewer cardiovascular events occurred and there were fewer amputations (24% vs. 68%).
CONCLUSIONS
On multivariable analysis: age, renal failure, chronic lung disease, coronary artery disease, postoperative complications and previous cardiovascular events were associated with an increased risk mortality rate. Preoperative haemoglobin influenced proportionally such that for every 1mg /dl increase, the probability of mortality decreases by 0.81. Preoperative anaemia, especially when haemoglobin is inferior to 10mg/dl, is associated with an increased risk of death and amputation.
Identifiants
pubmed: 29650265
pii: S0025-7753(18)30143-X
doi: 10.1016/j.medcli.2018.01.029
pii:
doi:
Substances chimiques
Hemoglobin A
9034-51-9
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
spa
Sous-ensembles de citation
IM
Pagination
6-12Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2018 The Author(s). Published by Elsevier España, S.L.U. All rights reserved.