Pre-operative Anemia as a Risk Factor of Morbidity and Mortality in Valvular Surgeries: Preoperative Anemia and Valvular Surgeries

Sardar Saud Abbas; Muhammad Wasim Sajjad; Hamid Naeem; Mujahid Ul Islam; Imran Khan; Ahsan Sabir; Owais Imran; Umair Arshad; Syed Nauman Shah; Rimshah Afridi

doi:10.54393/pjhs.v5i03.1269

Authors

Sardar Saud Abbas Department of Cardiothoracic Anesthesia, Rehman Medical Institute, Peshawar, Pakistan
Muhammad Wasim Sajjad Department of Cardiothoracic Surgery, Rehman Medical Institute, Peshawar, Pakistan
Hamid Naeem Cardiac Intensive Care Unit, Rehman Medical Institute, Peshawar, Pakistan
Mujahid Ul Islam Department of Cardiothoracic Anesthesia, Rehman Medical Institute, Peshawar, Pakistan
Imran Khan Department of Cardiothoracic Surgery, Rehman Medical Institute, Peshawar, Pakistan
Ahsan Sabir Department of Cardiothoracic Anesthesia, Rehman Medical Institute, Peshawar, Pakistan
Owais Imran Cardiac Intensive Care Unit, Rehman Medical Institute, Peshawar, Pakistan
Umair Arshad Department of General Anesthesia, Peshawar General Hospital, Peshawar, Pakistan
Syed Nauman Shah Department of Cardiothoracic Surgery, Rehman Medical Institute, Peshawar, Pakistan
Rimshah Afridi Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i03.1269

Keywords:

Anemia, Hemoglobin, Hematocrit, Heart Failure, Morbidity, Red Cell Concentrate, Valvular Surgeries

Abstract

Pre-operative anemia can be a hindrance to speedy recovery and will increase blood transfusion intraoperative and post operatively. Objective: To find a correlation between preoperative anemia and the subsequent morbidity and mortality rates in patients undergoing valvular surgeries. Methods: A retrospective observational study, involving 493 valvular surgeries’ patients. All patients had the same anesthetic and surgical techniques. According to the WHO, anemia is a hemoglobin level < 13 g/dl for men and <12 g/dl for women. Clinical variables were compared using chi-square and independent t-test. Results: The patients received cardiac surgery for valvular heart disorders and had an average age of 42.2±14.1 years, with 60.9% being male. Most patients exhibited NYHA III (48.9%) and CCS III (36.5%) functional class symptoms. Highest comorbidity was hypertension (35.1%), followed by diabetes (14.4%) and dyslipidemia (6.5%). 43.2% were anemic and older than non-anemic individuals (P=0.02). Anemic people had a significantly greater incidence of HTN (P 0.02) and DM (P < 0.001). Both groups exhibited identical perfusion and cross-clamp periods (P=0.4 vs. P=0.3). Though not statistically significant (P=0.08), non-anemic patients needed more intraoperative blood or blood product transfusions. Patients with anemia have worse outcomes, including increased rates of in-hospital mortality (P=0.03), extended artificial breathing (P=0.04), and postoperative blood/product transfusion (P<0.001). 44.8% of anemic individuals needed RCC, 41.9% FFP, and 41.4% platelets. Conclusions: anemia is associated with the poorest post-operative results. There is conflicting information about the impact of preoperative anemia, particularly iron deficiency anemia, on valvular surgery.

Author Biography

Mujahid Ul Islam, Department of Cardiothoracic Anesthesia, Rehman Medical Institute, Peshawar, Pakistan

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