The Association Between Preoperative Anemia and 30-Day Mortality and Morbidity in Noncardiac Surgical Patients

• DOI: 10.1213/ane.0b013e31828b347d
• Publication Date: 2013-03-22T21:19:49Z
• Authors: Leif Saager; Alparslan Turan; Luke F. Reynolds; Jarrod E. Dalton; Edward J. Mascha; Andrea Kurz
• Keywords: Adult; Male; Time Factors; Anemia; Middle Aged; 3. Good health; 03 medical and health sciences; Postoperative Complications; 0302 clinical medicine; Preoperative Care; Humans; Female; Prospective Studies; Morbidity; Aged; Retrospective Studies

Anemia has been associated with increased postoperative morbidity and mortality. We used the American College of Surgeons National Surgical Quality Improvement Program database to retrospectively assess relationship between preoperative anemia 30-day mortality in noncardiac surgical patients, careful distinguish confounding variables from mediator variables.Each patient was matched one without using propensity matching on potentially baseline variables. Logistic regression evaluate morbidity. The primary hypothesis evaluated after adjusting for covariables showing residual imbalance matching.Within database, 574,860 971,455 cases met our inclusion criteria, among those 145,218 (25.3%) were anemic at baseline. unadjusted odds ratio (95% confidence interval) comparing patients nonanemic 4.69 (4.01-5.49). Among propensity-matched group 238,596 total effect (i.e., not variables) estimated as an 1.59 (1.42-1.78). After suspected variables, only weakly 1.24 (1.10-1.40) mortality.Preoperative appears be diseases that markedly increase per se is a rather weak independent predictor Our analysis also illustrates how analyzing large variable-rich registries challenges investigators discriminate i.e., factors might considered "causal pathways" exposure or intervention outcome.