Preoperative anaemia is associated with poor clinical outcome in non-cardiac surgery patients.
Preoperative anaemia is associated with poor clinical outcome in non-cardiac surgery patients.
复制标题
术前贫血与非心脏手术患者的不良临床结果相关。
DOI：
10.1097/01.sa.0000464096.89876.ad
复制
发表时间：
2014
期刊：
影响因子：
--
通讯作者：
P. Metnitz
中科院分区：
文献类型：
--
作者：
D. Baron;Helene Hochrieser;M. Posch;B. Metnitz;A. Rhodes;R. Moreno;R. Pearse;P. Metnitz
背景
回顾性研究表明，术前贫血与术后不良结局相关。本研究的目的是描述接受非心脏和非神经住院手术的贫血患者的死亡率和重症监护资源使用模式。
方法
我们对一项大型前瞻性研究进行了二次分析，该研究描述了28个欧洲国家的围手术期护理和生存率。在7天期间接受住院手术的至少16岁的患者被纳入研究。收集了住院死亡率、住院时间、入住重症监护室和重症监护资源使用的数据。进行多变量logistic回归分析，以了解术前血红蛋白（Hb）水平对住院死亡率的影响。
结果
我们在分析中纳入了39309例患者。术前贫血在男性和女性中的患病率都很高（分别为31.1%和26.5%）。多变量分析显示，重度[比值比2.82（95%置信区间2.06-3.85）]或中度[1.99（1.67-2.37）]贫血患者的住院死亡率高于术前Hb浓度正常的患者。此外，贫血患者的住院时间（P<0.001）和术后入住重症监护室（P<0.001）均大于Hb浓度正常的患者。
结论
贫血在非心脏和非神经外科患者中很常见，与临床结局不良和医疗资源使用增加有关。
临床试验注册
NCT01203605（ClinicalTrials.gov）。
BACKGROUND
Retrospective studies suggest that preoperative anaemia is associated with poor outcomes after surgery. The objective of this study was to describe mortality rates and patterns of intensive care resource use for patients with anaemia undergoing non-cardiac and non-neurological in-patient surgery.
METHODS
We performed a secondary analysis of a large prospective study describing perioperative care and survival in 28 European nations. Patients at least 16 yr old undergoing in-patient surgery during a 7 day period were included in the study. Data were collected for in-hospital mortality, duration of hospital stay, admission to intensive care, and intensive care resource use. Multivariable logistic regression analysis was performed to understand the effects of preoperative haemoglobin (Hb) levels on in-hospital mortality.
RESULTS
We included 39 309 patients in the analysis. Preoperative anaemia had a high prevalence in both men and women (31.1% and 26.5%, respectively). Multivariate analysis showed that patients with severe [odds ratio 2.82 (95% confidence interval 2.06-3.85)] or moderate [1.99 (1.67-2.37)] anaemia had higher in-hospital mortality than those with normal preoperative Hb concentrations. Furthermore, hospital length of stay (P<0.001) and postoperative admission to intensive care (P<0.001) were greater in patients with anaemia than in those with normal Hb concentrations.
CONCLUSIONS
Anaemia is common among non-cardiac and non-neurological surgical patients, and is associated with poor clinical outcome and increased healthcare resource use.
CLINICAL TRIAL REGISTRATION
NCT01203605 (ClinicalTrials.gov).
DOI：
10.1056/nejmoa1012452
发表时间：
2011-12-29
期刊：
The New England journal of medicine
影响因子：
--
作者：
Carson JL;Terrin ML;Noveck H;Sanders DW;Chaitman BR;Rhoads GG;Nemo G;Dragert K;Beaupre L;Hildebrand K;Macaulay W;Lewis C;Cook DR;Dobbin G;Zakriya KJ;Apple FS;Horney RA;Magaziner J;FOCUS Investigators
通讯作者：
FOCUS Investigators