TY - JOUR
T1 - Pre-operative anaemia and myocardial injury after noncardiac surgery
T2 - A retrospective study
AU - Kwon, Ji Hye
AU - Park, Jungchan
AU - Lee, Seung Hwa
AU - Lee, Jong Hwan
AU - Min, Jeong Jin
AU - Kim, Jihoon
AU - Oh, Ah Ran
AU - Seo, Wonho
AU - Hyeon, Cheol Won
AU - Yang, Kwangmo
AU - Choi, Jin Ho
AU - Lee, Sang Chol
AU - Kim, Kyunga
AU - Ahn, Joonghyun
AU - Gwon, Hyeon Cheol
N1 - Publisher Copyright:
© 2021 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.
PY - 2021/6/1
Y1 - 2021/6/1
N2 - BACKGROUNDPre-operative anaemia is associated with adverse outcomes of noncardiac surgery, but its association with myocardial injury after noncardiac surgery (MINS) has not been fully investigated.OBJECTIVEThe association between pre-operative anaemia and MINS.DESIGNA single-centre retrospective cohort study.SETTINGTertiary care referral centre.PATIENTSPatients with measured cardiac troponin (cTn) I levels after noncardiac surgery.INTERVENTIONSPatients were separated according to pre-operative anaemia (haemoglobin <13 g dl-1 in men and <12 g dl-1 in women). Anaemia was further stratified into mild and moderate-to-severe at a haemoglobin level threshold of 11 g dl-1.MAIN OUTCOME MEASURESThe primary outcome was MINS, defined as a peak cTn I level more than 99th percentile of the upper reference limit within 30 postoperative days.RESULTSData from a total of 35 170 patients were collected, including 22 062 (62.7%) patients in the normal group and 13 108 (37.3%) in the anaemia group. After propensity score matching, 11919 sets of patients were generated, and the incidence of MINS was significantly associated with anaemia [14.5 vs. 21.0%, odds ratio (OR) 1.57, 95% confidence interval (CI) 1.47 to 1.68, P < 0.001]. For the entire population, multivariable analysis showed a graded association between anaemia severity and MINS (OR 1.32, 95% CI 1.22 to 1.43, P < 0.001 for mild anaemia and OR 1.80, 95% CI 1.66 to 1.94, P < 0.001 for moderate-to-severe anaemia compared with the normal group) and a significantly higher incidence of MINS for moderate-to-severe anaemia than mild anaemia (18.6 vs. 28.6%, OR 1.37, 95% CI 1.25 to 1.50, P < 0.001). The estimated threshold for pre-operative haemoglobin associated with MINS was 12.2 g dl-1, with an area under the curve of 0.622.CONCLUSIONSPre-operative anaemia was independently associated with MINS, suggesting that MINS may be related to the association between anaemia and postoperative mortality.
AB - BACKGROUNDPre-operative anaemia is associated with adverse outcomes of noncardiac surgery, but its association with myocardial injury after noncardiac surgery (MINS) has not been fully investigated.OBJECTIVEThe association between pre-operative anaemia and MINS.DESIGNA single-centre retrospective cohort study.SETTINGTertiary care referral centre.PATIENTSPatients with measured cardiac troponin (cTn) I levels after noncardiac surgery.INTERVENTIONSPatients were separated according to pre-operative anaemia (haemoglobin <13 g dl-1 in men and <12 g dl-1 in women). Anaemia was further stratified into mild and moderate-to-severe at a haemoglobin level threshold of 11 g dl-1.MAIN OUTCOME MEASURESThe primary outcome was MINS, defined as a peak cTn I level more than 99th percentile of the upper reference limit within 30 postoperative days.RESULTSData from a total of 35 170 patients were collected, including 22 062 (62.7%) patients in the normal group and 13 108 (37.3%) in the anaemia group. After propensity score matching, 11919 sets of patients were generated, and the incidence of MINS was significantly associated with anaemia [14.5 vs. 21.0%, odds ratio (OR) 1.57, 95% confidence interval (CI) 1.47 to 1.68, P < 0.001]. For the entire population, multivariable analysis showed a graded association between anaemia severity and MINS (OR 1.32, 95% CI 1.22 to 1.43, P < 0.001 for mild anaemia and OR 1.80, 95% CI 1.66 to 1.94, P < 0.001 for moderate-to-severe anaemia compared with the normal group) and a significantly higher incidence of MINS for moderate-to-severe anaemia than mild anaemia (18.6 vs. 28.6%, OR 1.37, 95% CI 1.25 to 1.50, P < 0.001). The estimated threshold for pre-operative haemoglobin associated with MINS was 12.2 g dl-1, with an area under the curve of 0.622.CONCLUSIONSPre-operative anaemia was independently associated with MINS, suggesting that MINS may be related to the association between anaemia and postoperative mortality.
UR - https://www.scopus.com/pages/publications/85102205479
U2 - 10.1097/EJA.0000000000001421
DO - 10.1097/EJA.0000000000001421
M3 - Article
C2 - 33399380
AN - SCOPUS:85102205479
SN - 0265-0215
VL - 38
SP - 582
EP - 590
JO - European Journal of Anaesthesiology
JF - European Journal of Anaesthesiology
IS - 6
ER -