Preoperative Anemia in Hindfoot and Ankle Arthrodesis.
This is a retrospective study (n = 39) evaluating the postoperative outcomes of patients with mild to moderate preoperative anemia who underwent a hindfoot and/or ankle arthrodesis. In the study, 32 patients did not have preoperative anemia, and 7 had preoperative anemia. Mortality, length of hospital stay, blood transfusions, deep-vein thrombosis, infection, time to union, malunion, delayed union, nonunion, and ulceration were of particular interest. Comparative analyses between patients with preoperative anemia and those without were performed utilizing the independent samples t-test or by the nonparametric Mann-Whitney U-test. The Fisher exact test was used to analyze categorical data. The Shapiro-Wilk test was utilized to check normality. Statistical significance was defined at a 2-sided level of P <.05. Delayed union, nonunion, and malunion were all significantly increased in patients with preoperative anemia (P = .032, P = .004, and P = .028, respectively). Accordingly, the median total number of noninfectious complications (delayed union + nonunion + malunion) in patients with preoperative anemia (0.86 ± 0.38) was significantly higher than in patients without preoperative anemia (0.063 ± 0.25; P < .001). Patients with preoperative anemia had a significantly longer length of hospital stay in days (4.14 ± 2.61). Total infection was also significantly associated with preoperative anemia (P = .001). This study clearly demonstrated that infectious complications, noninfectious complications, and length of hospital stay in hindfoot and/or ankle arthrodesis was significantly affected by preoperative anemia. Thus, consideration should be given to addressing preoperative anemia prior to hindfoot and/or ankle arthrodesis.


METHODS
Level II Study.
Division of Foot and Ankle Surgery, West Penn Hospital, Pittsburgh, Pennsylvania.
Brian
B
Dix
Division of Foot and Ankle Surgery, West Penn Hospital, Pittsburgh, Pennsylvania.
Lisa
L
Grant-McDonald
Division of Foot and Ankle Surgery, West Penn Hospital, Pittsburgh, Pennsylvania.
Alan
A
Catanzariti
Division of Foot and Ankle Surgery, West Penn Hospital, Pittsburgh, Pennsylvania.
Karl
K
Saltrick
D000328:Adult; D000368:Aged; D000740:Anemia / Q000150:complications* / Q000175:diagnosis; D000843:Ankle Joint / Q000503:physiopathology / Q000601:surgery*; D001174:Arthrodesis / Q000009:adverse effects* / Q000379:methods; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005528:Foot / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011300:Preoperative Care / Q000379:methods*; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013530:Surgical Wound Infection / Q000175:diagnosis* / Q000453:epidemiology
ankle; comorbid conditions; general disorders; heel; rearfoot; surgical complications