Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

Accept all cookies Reject all non-essential cookies Find out more

The effects of preoperative moderate to severe anaemia on length of hospital stay: A propensity score-matched analysis in non-cardiac surgery patients.

Bulte CSE., Boer C., Hemmes SNT., Serpa Neto A., Binnekade JM., Hedenstierna G., Jaber S., Hiesmayr M., Hollmann MW., Mills GH., Vidal Melo MF., Pearse RM., Putensen C., Schmid W., Severgnini P., Wrigge H., Gama de Abreu M., Pelosi P., Schultz MJ., for the LAS VEGAS ., study–investigators ., the PROVE Network ., and the Clinical Trial Network of the European Society of Anaesthesiology .

BackgroundAnaemia is frequently recorded during preoperative screening and has been suggested to affect outcomes after surgery negatively.ObjectivesThe objectives were to assess the frequency of moderate to severe anaemia and its association with length of hospital stay.DesignPost hoc analysis of the international observational prospective 'Local ASsessment of VEntilatory management during General Anaesthesia for Surgery' (LAS VEGAS) study.Patients and settingThe current analysis included adult patients requiring general anaesthesia for non-cardiac surgery. Preoperative anaemia was defined as a haemoglobin concentration of 11 g dl-1 or lower, thus including moderate and severe anaemia according to World Health Organisation criteria.Main outcome measuresThe primary outcome was length of hospital stay. Secondary outcomes included hospital mortality, intra-operative adverse events and postoperative pulmonary complications (PPCs).ResultsHaemoglobin concentrations were available for 8264 of 9864 patients. Preoperative moderate to severe anaemia was present in 7.7% of patients. Multivariable analysis showed that preoperative moderate to severe anaemia was associated with an increased length of hospital stay with a mean difference of 1.3 ((95% CI 0.8 to 1.8) days; P < .001). In the propensity-matched analysis, this association remained present, median 4.0 [IQR 1.0 to 5.0] vs. 2.0 [IQR 0.0 to 5.0] days, P = .001. Multivariable analysis showed an increased in-hospital mortality (OR 2.9 (95% CI 1.1 to 7.5); P  = .029), and higher incidences of intra-operative hypotension (36.3 vs. 25.3%; P < .001) and PPCs (17.1 vs. 10.5%; P = .001) in moderately to severely anaemic patients. However, this was not confirmed in the propensity score-matched analysis.ConclusionsIn this international cohort of non-cardiac surgical patients, preoperative moderate to severe anaemia was associated with a longer duration of hospital stay but not increased intra-operative complications, PPCs or in-hospital mortality.Trial registrationThe LAS VEGAS study was registered at Clinicaltrials.gov, NCT01601223.

More information Original publication

DOI

10.1097/eja.0000000000001412

Type

Journal article

Publication Date

2021-06-01T00:00:00+00:00

Volume

38

Pages

571 - 581

Total pages

10

Addresses

F, r, o, m, , t, h, e, , D, e, p, a, r, t, m, e, n, t, , o, f, , A, n, a, e, s, t, h, e, s, i, o, l, o, g, y, ,, , A, m, s, t, e, r, d, a, m, , U, M, C, ,, , V, U, , U, n, i, v, e, r, s, i, t, y, , A, m, s, t, e, r, d, a, m, ,, , A, m, s, t, e, r, d, a, m, ,, , T, h, e, , N, e, t, h, e, r, l, a, n, d, s, , (, C, S, E, -, B, ,, , C, B, ), ,, , D, e, p, a, r, t, m, e, n, t, , o, f, , I, n, t, e, n, s, i, v, e, , C, a, r, e, , a, n, d, , L, a, b, o, r, a, t, o, r, y, , o, f, , E, x, p, e, r, i, m, e, n, t, a, l, , I, n, t, e, n, s, i, v, e, , C, a, r, e, , a, n, d, , A, n, a, e, s, t, h, e, s, i, a, , (, L, ·, E, ·, I, ·, C, ·, A, ), ,, , A, m, s, t, e, r, d, a, m, , U, M, C, ,, , U, n, i, v, e, r, s, i, t, y, , o, f, , A, m, s, t, e, r, d, a, m, ,, , A, m, s, t, e, r, d, a, m, ,, , T, h, e, , N, e, t, h, e, r, l, a, n, d, s, , (, S, N, T, -, H, ,, , A, S, -, N, ,, , J, M, -, B, ,, , M, J, S, ), ,, , D, e, p, a, r, t, m, e, n, t, , o, f, , A, n, a, e, s, t, h, e, s, i, o, l, o, g, y, ,, , A, m, s, t, e, r, d, a, m, , U, M, C, ,, , U, n, i, v, e, r, s, i, t, y, , o, f, , A, m, s, t, e, r, d, a, m, ,, , A, m, s, t, e, r, d, a, m, ,, , T, h, e, , N, e, t, h, e, r, l, a, n, d, s, , (, S, N, T, -, H, ,, , M, W, -, H, ), ,, , D, e, p, a, r, t, m, e, n, t, , o, f, , C, r, i, t, i, c, a, l, , C, a, r, e, , M, e, d, i, c, i, n, e, ,, , H, o, s, p, i, t, a, l, , I, s, r, a, e, l, i, t, a, , A, l, b, e, r, t, , E, i, n, s, t, e, i, n, ,, , S, ã, o, , P, a, o, l, o, ,, , B, r, a, z, i, l, , (, A, S, -, N, ), ,, , H, e, d, e, n, s, t, i, e, r, n, a, , L, a, b, o, r, a, t, o, r, y, ,, , D, e, p, a, r, t, m, e, n, t, , o, f, , S, u, r, g, i, c, a, l, , S, c, i, e, n, c, e, s, ,, , U, p, p, s, a, l, a, , U, n, i, v, e, r, s, i, t, y, ,, , U, p, p, s, a, l, a, ,, , S, w, e, d, e, n, , (, G, H, ), ,, , M, o, n, t, p, e, l, l, i, e, r, , U, n, i, v, e, r, s, i, t, y, , H, o, s, p, i, t, a, l, ,, , S, a, i, n, t, , E, l, o, i, , I, n, t, e, n, s, i, v, e, , C, a, r, e, , U, n, i, t, , a, n, d, , P, h, y, M, e, d, E, x, p, ,, , U, n, i, v, e, r, s, i, t, y, , o, f, , M, o, n, t, p, e, l, l, i, e, r, ,, , I, N, S, E, R, M, ,, , C, N, R, S, ,, , M, o, n, t, p, e, l, l, i, e, r, ,, , F, r, a, n, c, e, , (, S, J, ), ,, , D, i, v, i, s, i, o, n, , o, f, , C, a, r, d, i, a, c, ,, , T, h, o, r, a, c, i, c, ,, , V, a, s, c, u, l, a, r, , A, n, a, e, s, t, h, e, s, i, a, , a, n, d, , I, n, t, e, n, s, i, v, e, , C, a, r, e, ,, , M, e, d, i, c, a, l, , U, n, i, v, e, r, s, i, t, y, , o, f, , V, i, e, n, n, a, ,, , V, i, e, n, n, a, ,, , A, u, s, t, r, i, a, , (, M, H, ,, , W, S, ), ,, , O, p, e, r, a, t, i, n, g, , S, e, r, v, i, c, e, s, ,, , C, r, i, t, i, c, a, l, , C, a, r, e, , a, n, d, , A, n, a, e, s, t, h, e, s, i, a, ,, , S, h, e, f, f, i, e, l, d, , T, e, a, c, h, i, n, g, , H, o, s, p, i, t, a, l, s, ,, , S, h, e, f, f, i, e, l, d, , a, n, d, , U, n, i, v, e, r, s, i, t, y, , o, f, , S, h, e, f, f, i, e, l, d, ,, , S, h, e, f, f, i, e, l, d, ,, , U, K, , (, G, H, -, M, ), ,, , D, e, p, a, r, t, m, e, n, t, , o, f, , A, n, a, e, s, t, h, e, s, i, a, ,, , C, r, i, t, i, c, a, l, , C, a, r, e, , a, n, d, , P, a, i, n, , M, e, d, i, c, i, n, e, ,, , M, a, s, s, a, c, h, u, s, e, t, t, s, , G, e, n, e, r, a, l, , H, o, s, p, i, t, a, l, ,, , B, o, s, t, a, n, ,, , M, A, ,, , U, S, A, , (, M, F, -, V, M, ), ,, , Q, u, e, e, n, , M, a, r, y, , U, n, i, v, e, r, s, i, t, y, , o, f, , L, o, n, d, o, n, ,, , L, o, n, d, o, n, ,, , U, K, , (, R, M, -, P, ), ,, , D, e, p, a, r, t, m, e, n, t, , o, f, , A, n, a, e, s, t, h, e, s, i, o, l, o, g, y, , a, n, d, , I, n, t, e, n, s, i, v, e, , C, a, r, e, , M, e, d, i, c, i, n, e, ,, , U, n, i, v, e, r, s, i, t, y, , H, o, s, p, i, t, a, l, , B, o, n, n, ,, , B, o, n, n, ,, , G, e, r, m, a, n, y, , (, C, P, ), ,, , D, e, p, a, r, t, m, e, n, t, , o, f, , B, i, o, t, e, c, h, n, o, l, o, g, y, , a, n, d, , S, c, i, e, n, c, e, s, , o, f, , L, i, f, e, ,, , A, S, S, T, , S, e, t, t, e, , L, a, g, h, i, , O, s, p, e, d, a, l, e, , d, i, , C, i, r, c, o, l, o, , e, , F, o, n, d, a, z, i, o, n, e, , M, a, c, c, h, i, ,, , U, n, i, v, e, r, s, i, t, y, , o, f, , I, n, s, u, b, r, i, a, ,, , V, a, r, e, s, e, ,, , I, t, a, l, y, , (, P, S, ), ,, , D, e, p, a, r, t, m, e, n, t, , o, f, , A, n, a, e, s, t, h, e, s, i, o, l, o, g, y, , a, n, d, , I, n, t, e, n, s, i, v, e, , C, a, r, e, , M, e, d, i, c, i, n, e, ,, , U, n, i, v, e, r, s, i, t, y, , o, f, , L, e, i, p, z, i, g, ,, , L, e, i, p, z, i, g, ,, , G, e, r, m, a, n, y, , (, H, W, ), ,, , D, e, p, a, r, t, m, e, n, t, , o, f, , A, n, a, e, s, t, h, e, s, i, o, l, o, g, y, , a, n, d, , I, n, t, e, n, s, i, v, e, , C, a, r, e, , M, e, d, i, c, i, n, e, ,, , P, u, l, m, o, n, a, r, y, , E, n, g, i, n, e, e, r, i, n, g, , G, r, o, u, p, ,, , U, n, i, v, e, r, s, i, t, y, , H, o, s, p, i, t, a, l, , C, a, r, l, , G, u, s, t, a, v, , C, a, r, u, s, ,, , T, e, c, h, n, i, s, c, h, e, , U, n, i, v, e, r, s, i, t, ä, t, , D, r, e, s, d, e, n, ,, , D, r, e, s, d, e, n, ,, , G, e, r, m, a, n, y, , (, M, G, D, -, A, ), ,, , D, i, p, a, r, t, i, m, e, n, t, o, , d, i, , S, c, i, e, n, z, e, , C, h, i, r, u, r, g, i, c, h, e, , e, , D, i, a, g, n, o, s, t, i, c, h, e, , I, n, t, e, g, r, a, t, e, ,, , U, n, i, v, e, r, s, i, t, à, , d, e, g, l, i, , S, t, u, d, i, , d, i, , G, e, n, o, v, a, ,, , G, e, n, o, v, a, ,, , I, t, a, l, y, , (, P, P, ), ,, , I, R, C, C, S, , O, s, p, e, d, a, l, e, , P, o, l, i, c, l, i, n, i, c, o, , S, a, n, , M, a, r, t, i, n, o, ,, , G, e, n, o, v, a, ,, , I, t, a, l, y, , (, P, P, ), ,, , M, a, h, i, d, o, l, , O, x, f, o, r, d, , T, r, o, p, i, c, a, l, , M, e, d, i, c, i, n, e, , R, e, s, e, a, r, c, h, , U, n, i, t, , (, M, O, R, U, ), ,, , M, a, h, i, d, o, l, , U, n, i, v, e, r, s, i, t, y, ,, , B, a, n, g, k, o, k, ,, , T, h, a, i, l, a, n, d, , (, M, J, S, ), ,, , N, u, f, f, i, e, l, d, , D, e, p, a, r, t, m, e, n, t, , o, f, , M, e, d, i, c, i, n, e, ,, , U, n, i, v, e, r, s, i, t, y, , o, f, , O, x, f, o, r, d, ,, , O, x, f, o, r, d, ,, , U, K, , (, M, J, S, ), .

Keywords

for the LAS VEGAS, study–investigators, the PROVE Network, and the Clinical Trial Network of the European Society of Anaesthesiology, Humans, Anemia, Postoperative Complications, Length of Stay, Prospective Studies, Adult, Propensity Score