• George Hallward, Nikhail Balani, Stuart McCorkell, James Roxburgh, and Victoria Cornelius.
• Anaesthesia and. Electronic address: George.Hallward@gstt.nhs.uk.
• J. Cardiothorac. Vasc. Anesth. 2016 Aug 1; 30 (4): 901-8.

ObjectivesPreoperative anemia is an established risk factor associated with adverse perioperative outcomes after cardiac surgery. However, limited information exists regarding the relationship between preoperative hemoglobin concentration and outcomes. The aim of this study was to investigate how outcomes are affected by preoperative hemoglobin concentration in a cohort of patients undergoing cardiac surgery.DesignA retrospective, observational cohort study.SettingA single-center tertiary referral hospital.ParticipantsThe study comprised 1,972 adult patients undergoing elective and nonelective cardiac surgery.InterventionsThe independent relationship of preoperative hemoglobin concentration was explored on blood transfusion rates, return to the operating room for bleeding and/or cardiac tamponade, postoperative intensive care unit (ICU) and in-hospital length of stay, and mortality.Measurements And Main ResultsThe overall prevalence of anemia was 32% (629/1,972 patients). For every 1-unit increase in hemoglobin (g/dL), blood transfusion requirements were reduced by 11%, 8%, and 3% for red blood cell units, platelet pools, and fresh frozen plasma units, respectively (adjusted incident rate ratio 0.89 [95% CI 0.87-0.91], 0.92 [0.88-0.97], and 0.97 [0.96-0.99]). For each 1-unit increase in hemoglobin (g/dL), the probability (over time) of discharge from the ICU and hospital increased (adjusted hazard ratio estimates 1.04 [1.00-1.08] and 1.12 [1.12-1.16], respectively).ConclusionsA lower preoperative hemoglobin concentration resulted in increased use of hospital resources after cardiac surgery. Each g/dL unit fall in preoperative hemoglobin concentration resulted in increased blood transfusion requirements and increased postoperative ICU and hospital length of stay.Copyright © 2016 Elsevier Inc. All rights reserved.

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