The relationship between pre-operative hemoglobin concentration, utilization of hospital resources and outcomes in cardiac surgery

George Hallward, Nikhail Balani, Stuart McCorkell, James Roxburgh, Victoria Cornelius

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)
330 Downloads (Pure)

Abstract

AbstractObjectives Pre-operative anemia is an established risk factor associated with adverse peri - operative outcomes after cardiac surgery. However, limited information exists regarding the relationship between pre-operative hemoglobin and outcomes. The aim of this study was to investigate how outcomes are affected by pre-operative hemoglobin concentration in a cohort of patients undergoing cardiac surgery. Study design A retrospective observational cohort study. Setting A single center tertiary referral hospital. Participants 1972 adult patients undergoing elective and non – elective cardiac surgery. Interventions/Observations The independent relationship of pre-operative hemoglobin concentration was explored on blood transfusion rates, return to theatre for bleeding and/or cardiac tamponade, post-operative intensive care unit (ICU) and in - hospital length of stay and mortality. Results The overall prevalence of anemia was 32% (629 / 1972 patients). For every one unit increase in hemoglobin (g/dl), blood transfusion requirements were reduced by 11%, 8% and 3% for red blood cell units, platelet pools and fresh frozen plasma units respectively (adjusted incident rate ratio 0.89 (95% CI 0.87,0.91), 0.92 (0.88,0.97) and 0.97 (0.96,0.99). For each one unit increase in hemoglobin (g/dl) the probability (over time) of discharge from ICU and hospital increased (adjusted hazard ratio estimates 1.04 (1.00, 1.08) and 1.12 (1.12, 1.16) respectively). Conclusion A lower pre – operative hemoglobin concentration results in increased use of hospital resources after cardiac surgery. Each g/dl unit fall in pre – operative hemoglobin concentration results in increased blood transfusion requirements and increased post –operative ICU and hospital length of stay.
Original languageEnglish
JournalJournal of Cardiothoracic and Vascular Anesthesia
DOIs
Publication statusE-pub ahead of print - 12 Feb 2016

Keywords

  • Preoperative
  • hemoglobin
  • anemia
  • cardiac surgery
  • outcomes.

Fingerprint

Dive into the research topics of 'The relationship between pre-operative hemoglobin concentration, utilization of hospital resources and outcomes in cardiac surgery'. Together they form a unique fingerprint.

Cite this