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., LAS VEGAS None., study–investigators None., PROVE Network None., and the Clinical Trial Network of the European Society of Anaesthesiology None.
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 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.