Preoperative Anemia as a Negative Risk Factor for Coronary Artery Bypass Grafting Surgery: A Retrospective Study
DOI:
https://doi.org/10.37762/jgmds.11-1.438Keywords:
ishcemic heart disease, coronary artery bypass grafting, anemiaAbstract
OBJECTIVES
The objective of this study is to check the effects of Anemia on mortality and morbidity in patients having ischemic heart disease and undergoing coronary artery bypass graft surgery (CABG).
METHODOLOGY
The study involved all the patients who underwent isolated coronary artery bypass graft surgery from July 2019 to December 2022. The clinical data of patients was retrospectively collected from the departmental data pool and was then analyzed using the chi-square test and t-test. A p-value of less than 0.05 was considered significant.
RESULTS
The study included 2570 patients who underwent isolated CABG; 78.2% of patients were males with a mean age of 57.87±9.20. Hypertension was the most common comorbidity (68.9%), followed by dyslipidemia (53.7%) & Diabetes mellitus (49.9%). The preoperative mean hematocrit was 30.05±17.85. Of these 2570 patients, 52.37% were anaemic with a mean age of 58.69±9.05. Anemic patients had a significantly higher rate of IABP insertion (P 0.02) and intra-operative blood product transfusion (P <0.001). Anemic patients had a significantly higher incidence of in-hospital mortality (P 0.04) and a higher rate of postoperative blood product transfusion (P <0.001). There is no significant difference in terms of prolonged ventilation, reintubation, or readmission to ICU; however, nonanemic patients have a significantly higher rate of re-opening for bleeding/ tamponade (P 0.01).
CONCLUSION
Preoperative anaemia increases the mortality and morbidity in ischemic heart disease patients undergoing coronary artery bypass grafting. To improve the outcomes in CABG surgery, preoperative anaemia should be thoroughly investigated and treated to improve the outcomes of surgery.
Downloads
Metrics
References
World Health Organization. Worldwide prevalence of anaemia 1993-2005: WHO global database on anaemia; 2008 [cited February 2020]. Available from: https://www.who.int/vmnis/anaemia/prevalence/summary/anaemia_data_status_t2/en
Kanic V, Kompara G, Suran D, Glavnik Poznic N. Untangling the relationship between hemoglobin, peak troponin level, and mortality in patients with myocardial infarction. Bosn J Basic Med Sci. 2022 Sep 16;22(5):791-7
Padmanabhan H, Siau K, Curtis J, Ng A, Menon S, Luckraz H et al. Preoperative anemia and outcomes in cardiovascular surgery: systematic review and meta-analysis. Ann Thorac Surg. 2019 Dec 1;108(6):1840-8
Kunadian V, Mehran R, Lincoff AM, Feit F, Manoukian SV, Hamon M, et al. Effect of anemia on frequency of short- and long-term clinical events in acute coronary syndromes (from the acute catheterization and urgent intervention triage strategy trial). Am J Cardiol. 2014;114(12):1823-9
Hubert M, Gaudriot B, Biedermann S, Gouezec H, Sylvestre E, Bouzille G, et al. Impact of preoperative iron deficiency on blood transfusion in elective cardiac surgery. J Cardiothorac Vasc Anesth. 2019;33(8):2141-50
Lanser L, Fuchs D, Scharnagl H, Grammer T, Kleber ME, März W et al. Anemia of chronic disease in patients with cardiovascular disease. Front Cardiovasc Med. 2021 Aug 12;8:666638
Gómez-Ramirez S, Jericó C, Muñoz M. Perioperative anemia: prevalence, consequences and pathophysiology. Transfus Apher Sci. 2019 Aug 1;58(4):369-74
Cappellini MD, Motta I. Anemia in Clinical Practice-Definition and Classification: Does Hemoglobin Change With Aging? Hematol. 2015 Oct 1;52(4):261-9
Boening A, Boedeker RH, Scheibelhut C, Rietzschel J, Roth P, Schönburg M. Anemia before coronary artery bypass surgery as additional risk factor increases the perioperative risk. Ann Thorac Surg. 2011;92(3):805-10
Barbieri J, Fontela PC, Winkelmann ER, Zimmermann CE, Sandri YP, Mallet EK et al. Anemia in patients with type 2 diabetes mellitus. Anemia. 2015 Oct;2015:354737
Olum R, Bongomin F, Kaggwa MM, Andia-Biraro I, Baluku JB. Anemia in diabetes mellitus in Africa: a systematic review and meta-analysis. Diabetes Metab Syndr. 2021 Sep 1;15(5):102260
Ranucci M, Di Dedda U, Castelvecchio S, Menicanti L, Frigiola A, Pelissero G et al. Impact of preoperative anemia on outcome in adult cardiac surgery: A propensity-matched analysis
Soh S, Shim JK, Song JW, Kang B, Kwak YL. Perioperative Nadir Hemoglobin Concentration and Outcome in Off-Pump Coronary Artery Bypass Surgery - A Retrospective Review. Circ J. 2020;85(1):37-43
Surgenor SD. Gordon R. DeFoe: Mary P. Fillinger, Donald S. Likosky, Robert C. Groom, Cantwell Clark, Robert E. Helm, Robert S. Kramer, Bruce J. Leavitt, John D. Klemperer, Charles F. Krumholz, Benjamin M. Westbrook, Dean J. Galatis, Carmine Frumiento, Cathy S. Ross, Elaine M. Olmstead and Gerald T. O’Connor Intraoperative Red Blood Cell Transfusion During Coronary Artery Bypass Graft Surgery Increases the Risk of Postoperative Low-Output Heart Failure. Circulation. 2006;114:I-43–I-48
Lawler PR, Filion KB, Dourian T, Atallah R, Garfinkle M, Eisenberg MJ. Anemia and mortality in acute coronary syndromes: a systematic review and meta-analysis. Am Heart J. 2013 Feb 1;165(2):143-53.e5
Farías JG, Molina VM, Carrasco RA, Zepeda AB, Figueroa E, Letelier P et al. Antioxidant therapeutic strategies for cardiovascular conditions associated with oxidative stress. Nutrients. 2017 Sep 1;9(9):966
Oprea AD, Del Rio JM, Cooter M, Green CL, Karhausen JA, Nailer P et al. Pre- and postoperative anemia, acute kidney injury, and mortality after coronary artery bypass grafting surgery: a retrospective observational study. Can J Anaesth. 2018;65(1):46-59
Padmanabhan H, Aktuerk D, Brookes MJ, Nevill AM, Ng A, Cotton J et al. Anemia in cardiac surgery: next target for mortality and morbidity improvement? Asian Cardiovasc Thorac Ann. 2016 Jan;24(1):12-7
Spazzafumo L, Olivieri F, Sabbatinelli J, Galeazzi R, Recchioni R, Marcheselli F et al. Prognostic relevance of normocytic anemia in elderly patients affected by cardiovascular disease. J Geriatr Cardiol. 2021 Aug 8;18(8):654-62
Kapadohos T, Angelopoulos E, Vasileiadis I, Nanas S, Kotanidou A, Karabinis A et al.. Determinants of prolonged intensive care unit stay in patients after cardiac surgery: a prospective observational study. J Thorac Dis. 2017 Jan;9(1):70-9
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Robina Bangash, Imtiaz Ahmad, Mujahid Ul Islam, Azam Jan, Haseeb Ahmed, Muhammad Wasim Sajjad, Saifullah
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
