• Ane Abad-Motos, Javier Ripollés-Melchor, Carlos Jericó, Elvira Bisbe, Misericordia Basora, Maria J Colomina, Ángel Becerra-Bolaños, María Bermúdez-López, Cristina Massa-Gómez, Javier Albaladejo-Magdalena, Ana Solar-Herrera, Hanna Pérez-Chrzanowska, Carlos Yárnoz, Jacobo José Fedriani-de-Matos, Beatriz Blanco-Del-Val, David Fabián-González, Jorge Bellver, Juan M Redondo-Enríquez, Jordi Serrat-Puyol, Alfredo Abad-Gurumeta, Andrés Zorrilla-Vaca, César Aldecoa, José Antonio García-Erce, and POWER2 Study Investigators Group.
• Department of Anaesthesiology, Hospital Universitario Infanta Leonor, Madrid, Spain.
• Acta Anaesthesiol Scand. 2023 May 1; 67 (5): 629639629-639.

BackgroundPreoperative anaemia is associated with poor outcomes in surgical patients, but the preoperative haemoglobin cut-off that determines lower morbidity in total knee arthroplasty (TKA) and total hip arthroplasty (THA) is not well established.MethodsPlanned secondary analysis of data collected during a multicentre cohort study of patients undergoing THA and TKA in 131 Spanish hospitals during a single 2-month recruitment period. Anaemia was defined as haemoglobin <12 g dl-1 for females and < 13 g dl-1 for males. The primary outcome was the number of patients with 30-day in-hospital postoperative complications according to European Perioperative Clinical Outcome definitions and specific surgical TKA and THA complications. Secondary outcomes included the number of patients with 30-day moderate-to-severe complications, red blood cell transfusion, mortality, and length of hospital stay. Binary logistic regression models were constructed to assess association between preoperative Hb concentrations and postoperative complications, and variables significantly associated with the outcome were included in the multivariate model. The study sample was divided into 11 groups based on preoperative Hb values in an effort to identify the threshold at which increased postoperative complications occurred.ResultsA total of 6099 patients were included in the analysis (3818 THA and 2281 TKA), of whom 8.8% were anaemic. Patients with preoperative anaemia were more likely to suffer overall complications (111/539, 20.6% vs. 563/5560, 10.1%, p < .001) and moderate-to-severe complications (67/539, 12.4% vs. 284/5560, 5.1%, p < .001). Multivariable analysis showed preoperative haemoglobin ≥14 g dl-1 was associated with fewer postoperative complications.ConclusionPreoperative haemoglobin ≥14 g dl-1 is associated with a lower risk of postoperative complications in patients undergoing primary TKA and THA.© 2023 Acta Anaesthesiologica Scandinavica Foundation.

31 keywords...

hide…