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Revista Uruguaya de Cardiología
Print version ISSN 0797-0048On-line version ISSN 1688-0420
Abstract
RAMOS MALCUORI, Camila et al. Postoperative morbidity associated with iron deficiency and preoperative non-severe anemia in elective cardiac surgery. Rev.Urug.Cardiol. [online]. 2022, vol.37, n.1, e204. Epub Dec 01, 2022. ISSN 0797-0048. https://doi.org/10.29277/cardio.37.1.14.
Introduction:
anemia and iron deficiency are frequent in candidates for cardiac surgery and are associated with poorer postoperative results. Its therapeutic approach is not standardized. There are no local data on prevalence and prognosis.
Objective:
to assess whether non-severe anemia and iron deficiency are associated with poorer postoperative results in elective cardiac surgery in our patients.
Method:
prospective cohort study in two centers. Patients > 18 years of age who underwent elective cardiac surgery were included. Three groups were formed: 1) control, 2) isolated iron deficiency and 3) non-severe anemia. Preoperative, intraoperative and postoperative clinical and paraclinical outcomes were recorded. Univariate and multivariate analyzes were performed to determine statistical significance (p < 0.05).
Results:
167 patients were included, 68 years [60-74], 61.68% men. Mean LVEF 59% [45-60], EuroSCORE II 0.96 [0.76-1.35]. 96 revascularizations (57.49%), 39 valve replacements (23.35%) and 30 combined (17.96%), one thrombectomy and one aortic tube were carried out. The prevalence of isolated iron deficiency was 15.57%, total anemia 40.72% and anemia and/or iron deficiency 56.29%. The control group had fewer days of hospitalization (p = 0.0018) and the ferropenia group needed more red blood cells transfusions (p = 0.045). In the univariate analysis, groups 2 and 3 were associated with higher compound postoperative events (OR 2.86, p = 0.03, and OR 2.11, p = 0.03, respectively). Group 3 was associated with a higher probability of postoperative infection (OR 8.63, 1.03-72.12, p = 0.049). In the multivariate analysis, the hematocrit values were associated with renal failure (OR 1.14, 95% CI 1.02-1.28, p = 0.02).
Conclusions:
the prevalence of non-severe anemia and iron deficiency was high, it was associated with greater complications in the postoperative period and a longer hospital stay. It is necessary to protocolize its therapeutic approach.
Keywords : Anemia; Iron deficiency; Heart surgery.
