title: The Prevalence and Impact of Preoperative Anemia in Patients Undergoing Cardiac Surgery for Rheumatic Heart Disease.
abstract: OBJECTIVE
  Many observational studies have demonstrated an association between preoperative anemia and adverse outcomes after cardiac surgery. However, there is a paucity of data on the impact of anemia in patients undergoing cardiac surgeries for rheumatic heart disease (RHD). This study was designed to examine the prevalence and impact of preoperative anemia in patients undergoing cardiac surgery for RHD.
  
  
  METHODS
  Retrospective observational data analysis.
  
  
  METHODS
  Tertiary-care hospital.
  
  
  METHODS
  335 consecutive patients undergoing cardiac surgery for RHD from January 2009 to November 2014.
  
  
  METHODS
  No interventions.
  
  
  RESULTS
  Prevalence of preoperative anemia as per World Health Organization (WHO) definition was 51.95%. Mild and moderate anemias were present in 33.15% and 18.80%, respectively. The primary endpoint was in-hospital mortality, with an incidence of 26 (6.9%); the incidence of mortality in non-anemic, mildly anemic, and moderately anemic patients was 5.59%, 4.50%, and 19.04% (p = 0.003), respectively. Patients with moderate anemia utilized an average of 3 units of packed cells compared to 1 in non-anemic patients (p = 0.0001). A multiple regression analysis was performed to predict mortality from variables including anemia, EuroSCORE II, and perioperative blood transfusion. On adjusting for EuroSCORE II and severity of anemia, perioperative packed cell transfusion was associated with significant odds (odds ratio 2.218; confidence interval 1.517-2.986; p<0.0001) for mortality.
  
  
  CONCLUSIONS
  In patients undergoing cardiac surgery for RHD, there was high prevalence of preoperative anemia. Despite higher transfusion rates in moderately anemic patients, they had significantly lower Hb on CPB and in the postoperative period. Perioperative packed cell transfusion was associated significantly with mortality.
authors.affiliation: Ozone Anesthesia Group, Aurangabad, M.S. Electronic address: deepakborde2482@gmail.com.
authors.forename: Borde
authors.initials: B
authors.lastname: Deepak
authors.affiliation: Ozone Anesthesia Group, Aurangabad, M.S.
authors.forename: Asegaonkar
authors.initials: A
authors.lastname: Balaji
authors.affiliation: Ozone Anesthesia Group, Aurangabad, M.S.
authors.forename: Apsingekar
authors.initials: A
authors.lastname: Pramod
authors.affiliation: Ozone Anesthesia Group, Aurangabad, M.S.
authors.forename: Khade
authors.initials: K
authors.lastname: Sujit
authors.affiliation: Ozone Anesthesia Group, Aurangabad, M.S.
authors.forename: Futane
authors.initials: F
authors.lastname: Savani
authors.affiliation: Ozone Anesthesia Group, Aurangabad, M.S.
authors.forename: Khodve
authors.initials: K
authors.lastname: Bapu
authors.affiliation: Department of Cardiac Surgery, Seth Nandlal Dhoot Hospital, Aurangabad, M.S.
authors.forename: Puranik
authors.initials: P
authors.lastname: Manish
authors.affiliation: Department of Cardiac Surgery, M.G.M. Medical College and Hospital, Aurangabad, M.S.
authors.forename: Belapurkar
authors.initials: B
authors.lastname: Yogesh
authors.affiliation: Department of Cardiac Anesthesia, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, India.
authors.forename: Joshi
authors.initials: J
authors.lastname: Shreedhar
authors.affiliation: Department of Cardiac Anesthesia, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, India.
authors.forename: George
authors.initials: G
authors.lastname: Antony
mesh_terms: D000328:Adult; D000740:Anemia / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D001803:Blood Transfusion / Q000706:statistics & numerical data; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods / Q000706:statistics & numerical data; D015995:Prevalence; D012189:Retrospective Studies; D012214:Rheumatic Heart Disease / Q000150:complications* / Q000453:epidemiology / Q000601:surgery*; D012720:Severity of Illness Index
keywords: perioperative transfusion; preoperative anemia; rheumatic heart surgery