Perioperative medicine & outcomes
Effect of perioperative blood transfusion on preoperative haemoglobin levels as a risk factor for long-term outcomes in patients undergoing major noncardiac surgery: a prospective multicentre observational study
Authors' conclusion
Preoperative haemoglobin levels were significantly associated with 1-yr MACCEs and all-cause mortality. This effect was not mediated by perioperative RBC transfusions.
Study context
- Population
- Patients aged ≥50 yr undergoing elective major noncardiac surgery at four Swedish hospitals
- Participants
- 1,060 patients
- Exposure
- Preoperative haemoglobin with red blood cell (RBC) transfusion as mediator
- Outcome
- Co-primary: MACCEs and all-cause mortality
- Follow-up
- 1 yr
Methodological detailsmulticentre, mediation analysis
- Multicentre
- Mediation analysis
Main finding
As reported in the abstract
1-yr MACCEs and all-cause mortality
- 1-yr major adverse cardiovascular and cerebrovascular events (MACCEs), n (%)
- 171 (16.1%)
- Death within 1 yr, n (%)
- 105 (9.9%)
- Preoperative haemoglobin associated with 1-yr MACCEs (b; P=0.041)
- −0.015
- Preoperative haemoglobin associated with all-cause mortality (b; P<0.001)
- −0.028
- RBC transfusion volume not directly associated with outcomes; mediation of haemoglobin–1-yr MACCEs (b; P=0.451)
- −0.001
- Mediation by RBC transfusion of haemoglobin–all-cause mortality (b; P=0.293)
- −0.002
Observational data: associations, not effects.
Secondary outcomes
Composite of 30-day mortality, MACCEs, acute kidney injury (AKI), PE, anastomotic leak, postoperative infection
- No direct association (b; P=0.554)
- 0.006
- Significant mediating effect of RBC transfusions between preoperative haemoglobin and composite outcome
Original publication
Effect of perioperative blood transfusion on preoperative haemoglobin levels as a risk factor for long-term outcomes in patients undergoing major noncardiac surgery: a prospective multicentre observational study. Br J Anaesth. Published 16 October 2024. doi:10.
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