Cardiothoracic & vascular anesthesia
Preoperative Anemia and Postoperative Outcomes in Cardiac Surgery: A Mediation Analysis Evaluating Intraoperative Transfusion Exposures
Authors' conclusion
Preoperative anemia was associated with higher odds of AKI and longer hospitalizations in cardiac surgery.
Study context
- Population
- Adults undergoing CABG or valve surgery on CPB at an academic medical center, May 1, 2008–May 1, 2018
- Participants
- 4,117 adults
- Exposure
- Preoperative anemia vs no preoperative anemia
- Preoperative anemian = 1,234
- No preoperative anemian = 2,883reference
- Outcome
- Acute kidney injury (AKI)
Methodological detailshistorical observational cohort, single academic medical center, mediation analysis
- Historical observational cohort
- Single academic medical center
- Mediation analysis
Main finding
As reported in the abstract
Preoperative anemia vs No preoperative anemiaEstimate (CI)P value
Multivariable analysis; total effect
absolute difference 6.4%(4.2%–8.7%)
P < 0.001Average direct effect of preoperative anemia
absolute difference (direct effect) 5.9%(3.6%–8.3%)
P < 0.001- Percent of total effect mediated by intraoperative red blood cell (RBC) transfusions
- 7.5% [−4.3% to 21.1%], P = .220
Observational data: associations, not effects.
Further findings
| Outcome | Absolute increase in probability of AKI (CI) | P value | |
|---|---|---|---|
| AKI by preoperative hemoglobin (9 vs 14 g/dL) | 11.9% (6.9%–17.5%) | P < 0.001 | |
| −1001020Difference (linear scale) |
| Outcome | Ratio of geometric mean LOS (CI) | P value |
|---|---|---|
| Hospital LOS | 1.07 (1.05–1.10) | P < 0.001 |
- Hospital LOS — Percent of total effect mediated through intraoperative RBC transfusion
- 38% (22%, 62%; P < .001)
Reoperation or vascular complications
- Preoperative anemia not associated with reoperation or vascular complications
Original publication
Preoperative Anemia and Postoperative Outcomes in Cardiac Surgery: A Mediation Analysis Evaluating Intraoperative Transfusion Exposures. Anesth Analg. Published 9 February 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →