Impact of preoperative anemia on cardiac surgery in octogenarians
Department of Cardiac Surgery, Instituto de Ciencias del Corazón (ICICOR), University Hospital, Avda. Ramón y Cajal, 3, 47005 Valladolid, Spain *Corresponding author. Tel.: +34 983 420 000 (Ext. 191); fax: +34 983 255 305. E-mail address : ycarrascal{at}hotmail.com (Y. Carrascal). Objectives: Preope...
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| Veröffentlicht in: | Interactive cardiovascular and thoracic surgery 2010-02, Vol.10 (2), p.249-255 |
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| creator | Carrascal, Yolanda Maroto, Laura Rey, Juvenal Arevalo, Adolfo Arroyo, Jaime Echevarria, Jose R Arce, Nuria Fulquet, Enrique |
| description | Department of Cardiac Surgery, Instituto de Ciencias del Corazón (ICICOR), University Hospital, Avda. Ramón y Cajal, 3, 47005 Valladolid, Spain
*Corresponding author. Tel.: +34 983 420 000 (Ext. 191); fax: +34 983 255 305. E-mail address : ycarrascal{at}hotmail.com (Y. Carrascal).
Objectives: Preoperative anemia has been related with adverse outcomes in elective valve replacement and CABG surgery. Impact of preoperative anemia on outcome in octogenarians submitted to cardiopulmonary bypass (CPB) has not yet been precisely described. Methods: We analyzed association between preoperative hemoglobin level, minimum intraoperative and immediate postoperative hematocrit (HCT), and other co-morbidities and occurrence of adverse outcomes in 227 octogenarians who underwent cardiac surgery. Results: Frequency of preoperative anemia was 41.9% (40.4% in male and 43.5% in female patients). Postoperative mortality was 13.2% (9% in non-anemic patients vs. 18.9% in anemic). 44.5% of patients suffered at least one postoperative adverse outcome (43.1% non-anemic vs. 46.3% anemic). In multivariate analysis (after adjusting independent preoperative risk factors for operative mortality and EuroSCORE) preoperative creatinin level [odds ratio (OR), 2.29; 95% confidence interval (CI), 1.06–4.98; P =0.035], immediate postoperative HCT |
| doi_str_mv | 10.1510/icvts.2009.220160 |
| format | Article |
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*Corresponding author. Tel.: +34 983 420 000 (Ext. 191); fax: +34 983 255 305. E-mail address : ycarrascal{at}hotmail.com (Y. Carrascal).
Objectives: Preoperative anemia has been related with adverse outcomes in elective valve replacement and CABG surgery. Impact of preoperative anemia on outcome in octogenarians submitted to cardiopulmonary bypass (CPB) has not yet been precisely described. Methods: We analyzed association between preoperative hemoglobin level, minimum intraoperative and immediate postoperative hematocrit (HCT), and other co-morbidities and occurrence of adverse outcomes in 227 octogenarians who underwent cardiac surgery. Results: Frequency of preoperative anemia was 41.9% (40.4% in male and 43.5% in female patients). Postoperative mortality was 13.2% (9% in non-anemic patients vs. 18.9% in anemic). 44.5% of patients suffered at least one postoperative adverse outcome (43.1% non-anemic vs. 46.3% anemic). In multivariate analysis (after adjusting independent preoperative risk factors for operative mortality and EuroSCORE) preoperative creatinin level [odds ratio (OR), 2.29; 95% confidence interval (CI), 1.06–4.98; P =0.035], immediate postoperative HCT <24% (OR, 2.78; 95% CI, 1.04–7.38; P =0.039), perioperative red blood cell (RBC) transfusion (OR, 1.58; 95% CI, 1.24–2.00; P =0.0001), peripheral vascular disease (OR, 4.92; 95% CI, 1.45–16.69; P =0.012) and urgent surgery (OR, 10.57; 95% CI, 2.54–43.91; P =0.0001) were identified as independent predictors for in-hospital mortality. Conclusions: Mortality and adverse postoperative outcome increase in anemic octogenarians undergoing cardiac surgery. Although mortality is directly related to immediate postoperative anemia, adverse outcomes mainly depend on associated co-morbidities.
Key Words: Octogenarians; Anemia; Cardiac surgery</description><identifier>ISSN: 1569-9293</identifier><identifier>EISSN: 1569-9285</identifier><identifier>DOI: 10.1510/icvts.2009.220160</identifier><identifier>PMID: 19889715</identifier><language>eng</language><publisher>England: Eur Assoc Cardio Surg</publisher><subject>Age Factors ; Aged, 80 and over ; Anemia - blood ; Anemia - complications ; Anemia - mortality ; Blood Vessel Prosthesis Implantation - adverse effects ; Blood Vessel Prosthesis Implantation - mortality ; Coronary Artery Bypass - adverse effects ; Coronary Artery Bypass - mortality ; Creatinine - blood ; Elective Surgical Procedures ; Erythrocyte Transfusion ; Female ; Hematocrit ; Hemoglobins - metabolism ; Hospital Mortality ; Humans ; Kaplan-Meier Estimate ; Length of Stay ; Logistic Models ; Male ; Odds Ratio ; Peripheral Vascular Diseases - complications ; Proportional Hazards Models ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome</subject><ispartof>Interactive cardiovascular and thoracic surgery, 2010-02, Vol.10 (2), p.249-255</ispartof><rights>Published by European Association for Cardio-Thoracic Surgery. All rights reserved. 2010</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c412t-e08b9841a101c1522036186c3236c00f568b453a636c5690d6447becfc987ed73</citedby><cites>FETCH-LOGICAL-c412t-e08b9841a101c1522036186c3236c00f568b453a636c5690d6447becfc987ed73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19889715$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Carrascal, Yolanda</creatorcontrib><creatorcontrib>Maroto, Laura</creatorcontrib><creatorcontrib>Rey, Juvenal</creatorcontrib><creatorcontrib>Arevalo, Adolfo</creatorcontrib><creatorcontrib>Arroyo, Jaime</creatorcontrib><creatorcontrib>Echevarria, Jose R</creatorcontrib><creatorcontrib>Arce, Nuria</creatorcontrib><creatorcontrib>Fulquet, Enrique</creatorcontrib><title>Impact of preoperative anemia on cardiac surgery in octogenarians</title><title>Interactive cardiovascular and thoracic surgery</title><addtitle>Interact CardioVasc Thorac Surg</addtitle><addtitle>Interact Cardiovasc Thorac Surg</addtitle><description>Department of Cardiac Surgery, Instituto de Ciencias del Corazón (ICICOR), University Hospital, Avda. Ramón y Cajal, 3, 47005 Valladolid, Spain
*Corresponding author. Tel.: +34 983 420 000 (Ext. 191); fax: +34 983 255 305. E-mail address : ycarrascal{at}hotmail.com (Y. Carrascal).
Objectives: Preoperative anemia has been related with adverse outcomes in elective valve replacement and CABG surgery. Impact of preoperative anemia on outcome in octogenarians submitted to cardiopulmonary bypass (CPB) has not yet been precisely described. Methods: We analyzed association between preoperative hemoglobin level, minimum intraoperative and immediate postoperative hematocrit (HCT), and other co-morbidities and occurrence of adverse outcomes in 227 octogenarians who underwent cardiac surgery. Results: Frequency of preoperative anemia was 41.9% (40.4% in male and 43.5% in female patients). Postoperative mortality was 13.2% (9% in non-anemic patients vs. 18.9% in anemic). 44.5% of patients suffered at least one postoperative adverse outcome (43.1% non-anemic vs. 46.3% anemic). In multivariate analysis (after adjusting independent preoperative risk factors for operative mortality and EuroSCORE) preoperative creatinin level [odds ratio (OR), 2.29; 95% confidence interval (CI), 1.06–4.98; P =0.035], immediate postoperative HCT <24% (OR, 2.78; 95% CI, 1.04–7.38; P =0.039), perioperative red blood cell (RBC) transfusion (OR, 1.58; 95% CI, 1.24–2.00; P =0.0001), peripheral vascular disease (OR, 4.92; 95% CI, 1.45–16.69; P =0.012) and urgent surgery (OR, 10.57; 95% CI, 2.54–43.91; P =0.0001) were identified as independent predictors for in-hospital mortality. Conclusions: Mortality and adverse postoperative outcome increase in anemic octogenarians undergoing cardiac surgery. Although mortality is directly related to immediate postoperative anemia, adverse outcomes mainly depend on associated co-morbidities.
Key Words: Octogenarians; Anemia; Cardiac surgery</description><subject>Age Factors</subject><subject>Aged, 80 and over</subject><subject>Anemia - blood</subject><subject>Anemia - complications</subject><subject>Anemia - mortality</subject><subject>Blood Vessel Prosthesis Implantation - adverse effects</subject><subject>Blood Vessel Prosthesis Implantation - mortality</subject><subject>Coronary Artery Bypass - adverse effects</subject><subject>Coronary Artery Bypass - mortality</subject><subject>Creatinine - blood</subject><subject>Elective Surgical Procedures</subject><subject>Erythrocyte Transfusion</subject><subject>Female</subject><subject>Hematocrit</subject><subject>Hemoglobins - metabolism</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Length of Stay</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Odds Ratio</subject><subject>Peripheral Vascular Diseases - complications</subject><subject>Proportional Hazards Models</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>1569-9293</issn><issn>1569-9285</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkM1PwyAchonROJ3-AV5Mb17s5Af9gOOy-LFkiRc9E0rphmlLhXZm_73MNnr1BCTP--blQegG8AJSwA9G7Xu_IBjzBSEYMnyCLiDNeMwJS09_75zO0KX3HxgDxxSfoxlwxngO6QVarptOqj6yVdQ5bTvtZG_2OpKtboyMbBsp6UojVeQHt9XuEJk2sqq3W91KZ2Trr9BZJWuvr6dzjt6fHt9WL_Hm9Xm9Wm5ilQDpY41ZwVkCEjAoSMNemgHLFCU0UxhXacaKJKUyC88wG5dZkuSFVpXiLNdlTufobuztnP0ctO9FY7zSdR2m2sGLnFIGNHwqkDCSylnvna5E50wj3UEAFkdx4kecOIoTo7iQuZ3ah6LR5V9iMhWA-xGwQ_evvmntzmx3X8Zp4RtZ16GdjHRIEUESTr8Bn6eE1A</recordid><startdate>20100201</startdate><enddate>20100201</enddate><creator>Carrascal, Yolanda</creator><creator>Maroto, Laura</creator><creator>Rey, Juvenal</creator><creator>Arevalo, Adolfo</creator><creator>Arroyo, Jaime</creator><creator>Echevarria, Jose R</creator><creator>Arce, Nuria</creator><creator>Fulquet, Enrique</creator><general>Eur Assoc Cardio Surg</general><general>European Association for Cardio-Thoracic Surgery</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20100201</creationdate><title>Impact of preoperative anemia on cardiac surgery in octogenarians</title><author>Carrascal, Yolanda ; Maroto, Laura ; Rey, Juvenal ; Arevalo, Adolfo ; Arroyo, Jaime ; Echevarria, Jose R ; Arce, Nuria ; Fulquet, Enrique</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c412t-e08b9841a101c1522036186c3236c00f568b453a636c5690d6447becfc987ed73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Age Factors</topic><topic>Aged, 80 and over</topic><topic>Anemia - blood</topic><topic>Anemia - complications</topic><topic>Anemia - mortality</topic><topic>Blood Vessel Prosthesis Implantation - adverse effects</topic><topic>Blood Vessel Prosthesis Implantation - mortality</topic><topic>Coronary Artery Bypass - adverse effects</topic><topic>Coronary Artery Bypass - mortality</topic><topic>Creatinine - blood</topic><topic>Elective Surgical Procedures</topic><topic>Erythrocyte Transfusion</topic><topic>Female</topic><topic>Hematocrit</topic><topic>Hemoglobins - metabolism</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Length of Stay</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Odds Ratio</topic><topic>Peripheral Vascular Diseases - complications</topic><topic>Proportional Hazards Models</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Carrascal, Yolanda</creatorcontrib><creatorcontrib>Maroto, Laura</creatorcontrib><creatorcontrib>Rey, Juvenal</creatorcontrib><creatorcontrib>Arevalo, Adolfo</creatorcontrib><creatorcontrib>Arroyo, Jaime</creatorcontrib><creatorcontrib>Echevarria, Jose R</creatorcontrib><creatorcontrib>Arce, Nuria</creatorcontrib><creatorcontrib>Fulquet, Enrique</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Interactive cardiovascular and thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Carrascal, Yolanda</au><au>Maroto, Laura</au><au>Rey, Juvenal</au><au>Arevalo, Adolfo</au><au>Arroyo, Jaime</au><au>Echevarria, Jose R</au><au>Arce, Nuria</au><au>Fulquet, Enrique</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of preoperative anemia on cardiac surgery in octogenarians</atitle><jtitle>Interactive cardiovascular and thoracic surgery</jtitle><stitle>Interact CardioVasc Thorac Surg</stitle><addtitle>Interact Cardiovasc Thorac Surg</addtitle><date>2010-02-01</date><risdate>2010</risdate><volume>10</volume><issue>2</issue><spage>249</spage><epage>255</epage><pages>249-255</pages><issn>1569-9293</issn><eissn>1569-9285</eissn><abstract>Department of Cardiac Surgery, Instituto de Ciencias del Corazón (ICICOR), University Hospital, Avda. Ramón y Cajal, 3, 47005 Valladolid, Spain
*Corresponding author. Tel.: +34 983 420 000 (Ext. 191); fax: +34 983 255 305. E-mail address : ycarrascal{at}hotmail.com (Y. Carrascal).
Objectives: Preoperative anemia has been related with adverse outcomes in elective valve replacement and CABG surgery. Impact of preoperative anemia on outcome in octogenarians submitted to cardiopulmonary bypass (CPB) has not yet been precisely described. Methods: We analyzed association between preoperative hemoglobin level, minimum intraoperative and immediate postoperative hematocrit (HCT), and other co-morbidities and occurrence of adverse outcomes in 227 octogenarians who underwent cardiac surgery. Results: Frequency of preoperative anemia was 41.9% (40.4% in male and 43.5% in female patients). Postoperative mortality was 13.2% (9% in non-anemic patients vs. 18.9% in anemic). 44.5% of patients suffered at least one postoperative adverse outcome (43.1% non-anemic vs. 46.3% anemic). In multivariate analysis (after adjusting independent preoperative risk factors for operative mortality and EuroSCORE) preoperative creatinin level [odds ratio (OR), 2.29; 95% confidence interval (CI), 1.06–4.98; P =0.035], immediate postoperative HCT <24% (OR, 2.78; 95% CI, 1.04–7.38; P =0.039), perioperative red blood cell (RBC) transfusion (OR, 1.58; 95% CI, 1.24–2.00; P =0.0001), peripheral vascular disease (OR, 4.92; 95% CI, 1.45–16.69; P =0.012) and urgent surgery (OR, 10.57; 95% CI, 2.54–43.91; P =0.0001) were identified as independent predictors for in-hospital mortality. Conclusions: Mortality and adverse postoperative outcome increase in anemic octogenarians undergoing cardiac surgery. Although mortality is directly related to immediate postoperative anemia, adverse outcomes mainly depend on associated co-morbidities.
Key Words: Octogenarians; Anemia; Cardiac surgery</abstract><cop>England</cop><pub>Eur Assoc Cardio Surg</pub><pmid>19889715</pmid><doi>10.1510/icvts.2009.220160</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Age Factors Aged, 80 and over Anemia - blood Anemia - complications Anemia - mortality Blood Vessel Prosthesis Implantation - adverse effects Blood Vessel Prosthesis Implantation - mortality Coronary Artery Bypass - adverse effects Coronary Artery Bypass - mortality Creatinine - blood Elective Surgical Procedures Erythrocyte Transfusion Female Hematocrit Hemoglobins - metabolism Hospital Mortality Humans Kaplan-Meier Estimate Length of Stay Logistic Models Male Odds Ratio Peripheral Vascular Diseases - complications Proportional Hazards Models Risk Assessment Risk Factors Time Factors Treatment Outcome |
| title | Impact of preoperative anemia on cardiac surgery in octogenarians |
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