• Clarissa Mendanha, Paulo C S Neto, Rogério B Borges, Isabela Sirtoli, Cleiton S Pando, Mariana Brandão, Alexandre Weber, Leo Sekini, and StefaniLuciana CadoreLC.
• From the Programa de Pós-Graduação em Medicina: Ciências Médicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil (CM, PCSN, LS, LCS), Biostatistics Unit - Research Unit (DIPE), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil (RBB), Anaesthesia and Perioperative Medicine Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil (IS, CSP, AW, LCS), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil (MB), Department of Internal Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil (LS), Department of Surgery, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil (LCS).
• Eur J Anaesthesiol. 2024 Sep 24.

BackgroundPreoperative anaemia is associated with poor postoperative outcomes; however, few studies have reported its prevalence in developing countries and its association with significant postoperative outcomes.ObjectiveWe aimed to identify the prevalence of anaemia and its association with postoperative outcomes in a major public hospital in Brazil.DesignRetrospective cohort study.SettingSingle-centre, 860-bed, quaternary university-affiliated teaching hospital in Southern Brazil.PatientsWe included adult patients who had undergone surgery between 2015 and 2019. Main outcome measures: The main outcome was the in-hospital 30-day postoperative mortality. According to the World Health Organisation, we defined anaemia and its sub-classification (mild, moderate, and severe). We developed Poisson regression models to examine the association between preoperative anaemia and outcomes.ResultsWe included 15 166 patients, of whom 6387 (42.1%) were anaemic. After adjustment for confounding factors, patients with anaemia had an increased risk of in-hospital 30-day postoperative mortality (relative risk (RR) 1.69, 95% confidence interval (CI) 1.44 to 1.99, P < 0.001). Mild [relative risk (RR) 1.38, 95% CI 1.12 to 1.71, P = 0.003], moderate (RR 1.73, 95% CI 1.43 to 2.10, P < 0.001), and severe anaemia (RR 2.43, 95% CI 1.92 to 3.07, P < 0.001) were associated with the primary outcome. Anaemia increased the transfusion risk (RR 4.44, 95% CI 3.90 to 5.06, P < 0.001) and postoperative intensive care unit (ICU) admission (RR 1.09, 95% CI 1.04 to 1.16, P = 0.001).ConclusionsFour out of 10 patients had anaemia. These patients had an increased risk of adverse postoperative outcomes. Comprehension of the magnitude and impact of anaemia is essential to establish interventions in low-resource scenarios to optimise the patient's journey.Study RegistrationInstitutional Review Board Registration number 40522820000005327 (Brazilian CEP/CONEP System, available in https://plataformabrasil.saude.gov.br/).Copyright © 2024 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.

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