Cardiothoracic & vascular anesthesia
Pre‐operative anaemia, red blood cell transfusion and mortality after cardiac surgery: a Netherlands Heart Registration mediation analysis
Main finding · 120-day mortalityResult — go to the resultAdjusted odds ratio 1.66 95% CI 1.47–1.87Authors' conclusion
A substantial part of the association between pre-operative anaemia and mortality after cardiac surgery is mediated by red blood cell transfusion during hospital stay.
Study context
- Population
- Adult cardiac surgery patients, Netherlands Heart Registration
- Participants
- 71,053 patients
- Exposure
- Pre-operative anaemia vs no anaemia; mediation by RBC transfusion
- Anaemian = 14,452
- Outcome
- 120-day mortality
- Follow-up
- 120 days
Methodological detailsmediation analysis, multivariable logistic regression, registry
- Mediation analysis
- Multivariable logistic regression
- Registry
Main finding
As reported in the abstract
Adjusted odds ratio
1.66
95% CI 1.47–1.87
Events by group
Anaemia vs No anaemia
aOR 1.66 (95% CI 1.47–1.87)
- Proportion of association mediated by RBC transfusion
- 58.9% (95%CI 41.3-76.5%)
Observational data: associations, not effects.
Further findings
RBC transfusion during hospital stay
P < 0.001
Proportion mediated by RBC transfusion, by age (subgroup)
- Aged ≥ 70 years
- 77.3%, 95%CI 43.1-100%
- Younger patients
- 39.3%, 95%CI 21.4-57.2%
Original publication
Pre‐operative anaemia, red blood cell transfusion and mortality after cardiac surgery: a Netherlands Heart Registration mediation analysis. Anaesthesia. Published 12 December 2025. doi:10.
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