Dataset from Ranucci M, Pavesi M, Pistuddi V, Baryshnikova E. Preoperative Anemia Correction in Cardiac Surgery: A Propensity-Matched Study. J Cardiothorac Vasc Anesth. 2021 Mar;35(3):874-881. doi: 10.1053/j.jvca.2020.07.015. Epub 2020 Jul 7. PMID: 32741609.

Abstract

Dataset from the article Ranucci M, Pavesi M, Pistuddi V, Baryshnikova E. Preoperative Anemia Correction in Cardiac Surgery: A Propensity-Matched Study. J Cardiothorac Vasc Anesth. 2021 Mar;35(3):874-881. doi: 10.1053/j.jvca.2020.07.015. Epub 2020 Jul 7. PMID: 32741609. ANEMIA IN CARDIAC surgery patients is a common condition. In a recent survey conducted in the United Kingdom, preoperative anemia was diagnosed in 23% to 45% of cardiac surgery patients, and it was more common in elderly patients, patients with diabetes, women, patients with low body mass index, and high-risk patients.1 Aside from hospital-acquired anemia (preoperative decrease of hemoglobin due to blood withdrawals, invasive procedures, and hemodilution), the most common cause of anemia is iron deficiency, followed by anemia of chronic disease.2 Preoperative anemia has been associated with worse outcomes in cardiac surgery,3-6 and the levels of hemoglobin (Hb) or hematocrit (HCT) before surgery are now included in a mortality risk score, with a relative risk increase of 18% per each percent point of HCT below 36%.7 In a recent randomized controlled trial, an ultrashort-term treatment with a combination of ferric carboxymaltose, erythropoietin, vitamin B12, and folates in patients with iron deficiency or anemia of any kind significantly reduced red blood cell (RBC) and total allogeneic blood product transfusions in patients undergoing cardiac surgery.8 However, this approach was not based on a specific treatment of the different kinds of anemia, and its ultra-short nature may have reduced the clinical impact of the drugs used to correct anemia. Therefore, there is presently a gap of knowledge with respect to the efficacy and clinical usefulness of a specific treatment aimed at starting days or weeks before surgery and one aimed at correcting anemia. Since 2017 at the authors’ institution, they have implemented a program of preoperative anemia correction for cardiac and noncardiac surgery patients. Cardiac surgery patients who can be examined as outpatients before being admitted to the hospital enter this program, which provides a targeted treatment for all anemic (Hb < 13 g/dL) patients. Due to organization issues, and the nature of the institution (a tertiary center admitting many patients from other Italian regions), a minority (about 20%) of the cardiac surgery patients have access to this facility. Therefore, a considerable number of anemic patients undergo cardiac surgery without anemia correction. The present study was a retrospective, propensity-matched analysis of the effects of preoperative anemia correction with a tailored strategy in cardiac surgery patients from 2017 to 2019.

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