Postoperative haemoglobin and anaemia-associated ischaemic events after major noncardiac surgery : A sex-stratified cohort study
Copyright © 2024 Elsevier Inc. All rights reserved..
STUDY OBJECTIVE: To determine the sex-specific associations between postoperative haemoglobin and mortality or complications reflecting ischaemia or inadequate oxygen supply after major noncardiac surgery.
DESIGN: A retrospective cohort study with prospective validation.
SETTING: A large university hospital health system in China.
PATIENTS: Men and women undergoing elective major noncardiac surgery.
INTERVENTIONS AND MEASUREMENTS: The primary exposure was nadir haemoglobin within 48 h after surgery. The outcome of interest was a composite of postoperative mortality or ischaemic events including myocardial injury, acute kidney injury and stroke within hospitalisation.
MAIN RESULTS: The study included 26,049 patients (15,757 men and 10,292 women). Low postoperative haemoglobin was a strong predictor of the composite outcome in both sexes, with the risk progressively increasing as the nadir haemoglobin concentration dropped below 130 g l-1 in men and 120 g l-1 in women (adjusted odds ratio [OR] 1.43, 95% CI 1.37-1.50 in men, and OR 1.45, 95% CI 1.35-1.55 in women, per 10 g l-1 decrease in postoperative nadir haemoglobin). Above these sex-specific thresholds, the change of nadir haemoglobin was no longer associated with odds of the composite outcome in either men or women. There was no significant interaction between patient sex and the association between postoperative haemoglobin and the composite outcome (Pinteraction = 0.673). Validation in an external prospective cohort (n = 2120) with systematic postoperative troponin and creatinine measurement confirmed our findings.
CONCLUSIONS: Postoperative haemoglobin levels following major noncardiac surgery were nonlinearly associated with ischaemic complications or mortality, without any clinically important interaction with patient sex.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:95 |
|---|---|
| Enthalten in: |
Journal of clinical anesthesia - 95(2024) vom: 11. März, Seite 111439 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Zhao, Bing-Cheng [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Anaemia |
|---|
| Anmerkungen: |
Date Revised 12.03.2024 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1016/j.jclinane.2024.111439 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM36960914X |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM36960914X | ||
| 003 | DE-627 | ||
| 005 | 20240313235102.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240313s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.jclinane.2024.111439 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1326.xml |
| 035 | |a (DE-627)NLM36960914X | ||
| 035 | |a (NLM)38471194 | ||
| 035 | |a (PII)S0952-8180(24)00068-0 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Zhao, Bing-Cheng |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Postoperative haemoglobin and anaemia-associated ischaemic events after major noncardiac surgery |b A sex-stratified cohort study |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 12.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024 Elsevier Inc. All rights reserved. | ||
| 520 | |a STUDY OBJECTIVE: To determine the sex-specific associations between postoperative haemoglobin and mortality or complications reflecting ischaemia or inadequate oxygen supply after major noncardiac surgery | ||
| 520 | |a DESIGN: A retrospective cohort study with prospective validation | ||
| 520 | |a SETTING: A large university hospital health system in China | ||
| 520 | |a PATIENTS: Men and women undergoing elective major noncardiac surgery | ||
| 520 | |a INTERVENTIONS AND MEASUREMENTS: The primary exposure was nadir haemoglobin within 48 h after surgery. The outcome of interest was a composite of postoperative mortality or ischaemic events including myocardial injury, acute kidney injury and stroke within hospitalisation | ||
| 520 | |a MAIN RESULTS: The study included 26,049 patients (15,757 men and 10,292 women). Low postoperative haemoglobin was a strong predictor of the composite outcome in both sexes, with the risk progressively increasing as the nadir haemoglobin concentration dropped below 130 g l-1 in men and 120 g l-1 in women (adjusted odds ratio [OR] 1.43, 95% CI 1.37-1.50 in men, and OR 1.45, 95% CI 1.35-1.55 in women, per 10 g l-1 decrease in postoperative nadir haemoglobin). Above these sex-specific thresholds, the change of nadir haemoglobin was no longer associated with odds of the composite outcome in either men or women. There was no significant interaction between patient sex and the association between postoperative haemoglobin and the composite outcome (Pinteraction = 0.673). Validation in an external prospective cohort (n = 2120) with systematic postoperative troponin and creatinine measurement confirmed our findings | ||
| 520 | |a CONCLUSIONS: Postoperative haemoglobin levels following major noncardiac surgery were nonlinearly associated with ischaemic complications or mortality, without any clinically important interaction with patient sex | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Anaemia | |
| 650 | 4 | |a Haemoglobin | |
| 650 | 4 | |a Noncardiac surgery | |
| 650 | 4 | |a Patient blood management | |
| 650 | 4 | |a Sex | |
| 700 | 1 | |a Xie, Yi-Shan |e verfasserin |4 aut | |
| 700 | 1 | |a Luo, Wen-Chi |e verfasserin |4 aut | |
| 700 | 1 | |a Lei, Shao-Hui |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Jia-Ming |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Xiao |e verfasserin |4 aut | |
| 700 | 1 | |a Dong, Ye-Hong |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Wei-Feng |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Ke-Xuan |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of clinical anesthesia |d 1996 |g 95(2024) vom: 11. März, Seite 111439 |w (DE-627)NLM013003399 |x 1873-4529 |7 nnns |
| 773 | 1 | 8 | |g volume:95 |g year:2024 |g day:11 |g month:03 |g pages:111439 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.jclinane.2024.111439 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 95 |j 2024 |b 11 |c 03 |h 111439 | ||