Saba Riaz, Imran Khan, Saira Gul, Madiha Iqbal, Shumaila Afshan, Abdul Waheed.
Effect of preoperative anemia on outcome after cardiac surgery.
J Cardiovascular Dis Jan ;11(3):65-9.

OBJECTIVE: Good anemic control in pre-operative phase is known to decrease mortality and morbidity after cardiac surgery. Thus, we studied the effect of preoperative anemia on outcome after cardiac surgery. MATERIAL AND METHODS: This comparative prospective observational study was conducted at Punjab Institute of Cardiology, Lahore from 1st March 2012 to 31st March 2013. Two hundered consecutive patients for cardiac surgery (Ischemic / valvular) aged ≥18 years were studied. All the surgeries were performed using cardiopulmonary bypass (CPB) and in hospital outcomes were recorded. RESULTS: Out of 200 patients, 140(70%) were male while 60(30%) were female. The mean age of the patients was 50.63±15.33 years and mean hemoglobin level was 12.20±1.98 mg/dl. Patients operated for coronary artery bypass grafting (CABG) were132 (66%) and 68 (34%) patients underwent valvular surgery. The prevalence of anemia was found to be 114(57%). Preoperative anemia was associated with prolonged hospital stay (CABG; 15.0±6.38 vs. 7.93±4.7 and valvular; 17.28±5.7 vs. 8.65±5.31), increased postoperative creatinine levels (CABG; 2.87±0.16 vs. 0.98±0.61 and valvular; 2.76±0.16 vs. 0.86±0.14) and greater blood transfusion rate (CABG;1.67±0.98 vs. 1.26±0.60 and valvular; 1.65±1.07 vs. 1.14±1.06) in cardiac surgery patients. Pre-operative anemic patients had markedly greater chance of suffering an adverse outcome after cardiac surgery. Post operative wound infection (3.03% vs. 2.94%), renal injury (19.69% vs. 10.29%), stroke (3.03% vs. 0), postoperative MI (6.06% vs. 4.41%) and AF (10.6% vs. 8.82%) were found to be higher in CABG patients as compared to valvular patients while reexploration (4.54% vs. 14.70%) was found to be higher in valvular group as compare to CABG in those patients who had preoperative anemia. CONCLUSION:In patients undergoing surgery for coronary artery disease and valvular heart disease, preoperative anemia is associated with increased in-hospital mortality and serious adverse outcomes.

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