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Pre-operative anaemia and myocardial injury after noncardiac surgery: A retrospective study.

Abstract：

BACKGROUND:Pre-operative anaemia is associated with adverse outcomes of noncardiac surgery, but its association with myocardial injury after noncardiac surgery (MINS) has not been fully investigated. OBJECTIVE:The association between pre-operative anaemia and MINS. DESIGN:A single-centre retrospective cohort study. SETTING:Tertiary care referral centre. PATIENTS:Patients with measured cardiac troponin (cTn) I levels after noncardiac surgery. INTERVENTIONS:Patients were separated according to pre-operative anaemia (haemoglobin <13 g dl-1 in men and <12 g dl-1 in women). Anaemia was further stratified into mild and moderate-to-severe at a haemoglobin level threshold of 11 g dl-1. MAIN OUTCOME MEASURES:The primary outcome was MINS, defined as a peak cTn I level more than 99th percentile of the upper reference limit within 30 postoperative days. RESULTS:Data from a total of 35 170 patients were collected, including 22 062 (62.7%) patients in the normal group and 13 108 (37.3%) in the anaemia group. After propensity score matching, 11919 sets of patients were generated, and the incidence of MINS was significantly associated with anaemia [14.5 vs. 21.0%, odds ratio (OR) 1.57, 95% confidence interval (CI) 1.47 to 1.68, P < 0.001]. For the entire population, multivariable analysis showed a graded association between anaemia severity and MINS (OR 1.32, 95% CI 1.22 to 1.43, P < 0.001 for mild anaemia and OR 1.80, 95% CI 1.66 to 1.94, P < 0.001 for moderate-to-severe anaemia compared with the normal group) and a significantly higher incidence of MINS for moderate-to-severe anaemia than mild anaemia (18.6 vs. 28.6%, OR 1.37, 95% CI 1.25 to 1.50, P < 0.001). The estimated threshold for pre-operative haemoglobin associated with MINS was 12.2 g dl-1, with an area under the curve of 0.622. CONCLUSIONS:Pre-operative anaemia was independently associated with MINS, suggesting that MINS may be related to the association between anaemia and postoperative mortality. TRIAL REGISTRATION:SMC 2019-08-048.

journal_name

Eur J Anaesthesiol

journal_title

European journal of anaesthesiology

authors

Kwon JH,Park J,Lee SH,Lee JH,Min JJ,Kim J,Oh AR,Seo W,Hyeon CW,Yang K,Choi JH,Lee SC,Kim K,Ahn J,Gwon HC

doi

10.1097/EJA.0000000000001421

subject

Has Abstract

pub_date

2021-01-04 00:00:00

eissn

0265-0215

issn

1365-2346

pii

00003643-900000000-98264

journal_volume

Publish Ahead of Print

pub_type

杂志文章

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Pre-operative anaemia and myocardial injury after noncardiac surgery: A retrospective study.