Perioperative medicine & outcomes
Relative contributions of anaemia and hypotension to myocardial infarction and renal injury: Post hoc analysis of the POISE-2 trial
Authors' conclusion
Postoperative anaemia and hypotension were meaningfully associated with both our primary composite and AKI. However, lack of significant interaction suggests that the effects of hypotension and anaemia are additive rather than multiplicative.
Study context
- Population
- Adults ≥45 years with known or suspected cardiovascular disease having noncardiac surgery, 135 hospitals in 23 countries, 2010–2013
- Participants
- 7,940 adults
- Comparison
- Lowest postoperative haemoglobin and duration of SBP <90 mmHg
- Primary endpoint
- Collapsed composite of:
- Nonfatal myocardial infarction (MI)
- All-cause mortality
- Follow-up
- 30 postoperative days
Methodological detailspost hoc analysis, multicentre
- Post hoc analysis
- Multicentre
Primary result
As reported in the abstract
Composite of:
- Nonfatal MI
- All-cause mortality
Patients with infarction or death within 30 postoperative days
409
5.2%
Secondary outcomes
Acute kidney injury (AKI)
- Patients developing AKI
- 417 (6.4%)
- Lowest haemoglobin <11 g dl −1 and duration of SBP <90 mmHg associated with greater hazard of AKI
- No significant multiplicative interaction on AKI
Exposure distribution · first four postoperative days
- Lowest postoperative haemoglobin, mean ± SD (g dl −1)
- 10 ± 2
- Patients with SBP <90 mmHg (daily duration 0 to 15 h)
- 24%
Original publication
Relative contributions of anaemia and hypotension to myocardial infarction and renal injury: Post hoc analysis of the POISE-2 trial. Eur J Anaesthesiol. Published 9 March 2023. doi:10.
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