Journal of cardiothoracic and vascular anesthesia · 2020
Preoperative Anemia as a Risk Factor for Postoperative Outcomes in Patients Undergoing Lung Transplantation.
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Hernandez-Morgan Marisa, Neelankavil Jacques, Grogan Tristan, Hong Bryant, Wingert Theodora, Methangkool Emily
Аннотация
OBJECTIVES: The aim of this study was to evaluate the effect of preoperative anemia on early postoperative outcomes in a population of patients undergoing lung transplantation.
DESIGN: Single-center retrospective study of lung transplantation recipients between April 2013 and June 2018. The primary outcome was hospital length of stay.
SETTING: Ronald Reagan UCLA Medical Center, Los Angeles, CA, a tertiary academic medical center.
PARTICIPANTS: Patients presenting from home for lung transplantation.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: A total of 435 patients underwent lung transplantation during the study period. After exclusion, 342 were included in the analysis. The prevalence of preoperative anemia was 54% (n = 183); however, only 11% of anemic patients received treatment for anemia before transplantation. Multivariate regression analysis indicated that lower hemoglobin levels were associated with longer hospital lengths of stay (p = 0.049). Preoperative anemia also was independently associated with an increased risk for redo surgery for bleeding (odds ratio 4.89; p = 0.007). No association between preoperative anemia and any of the other postoperative outcomes examined was found.
CONCLUSIONS: Preoperative anemia in patients undergoing lung transplantation is undertreated and independently associated with an increased risk for redo surgery for bleeding. Additional studies regarding reasons for this association and effect of treatment are necessary to improve outcomes.
DESIGN: Single-center retrospective study of lung transplantation recipients between April 2013 and June 2018. The primary outcome was hospital length of stay.
SETTING: Ronald Reagan UCLA Medical Center, Los Angeles, CA, a tertiary academic medical center.
PARTICIPANTS: Patients presenting from home for lung transplantation.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: A total of 435 patients underwent lung transplantation during the study period. After exclusion, 342 were included in the analysis. The prevalence of preoperative anemia was 54% (n = 183); however, only 11% of anemic patients received treatment for anemia before transplantation. Multivariate regression analysis indicated that lower hemoglobin levels were associated with longer hospital lengths of stay (p = 0.049). Preoperative anemia also was independently associated with an increased risk for redo surgery for bleeding (odds ratio 4.89; p = 0.007). No association between preoperative anemia and any of the other postoperative outcomes examined was found.
CONCLUSIONS: Preoperative anemia in patients undergoing lung transplantation is undertreated and independently associated with an increased risk for redo surgery for bleeding. Additional studies regarding reasons for this association and effect of treatment are necessary to improve outcomes.