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TITLE:

INFLUENCE OF PREOPERATIVE ANEMIA ON CARDIAC SURGERY OUTCOMES

AUTHORS:

Dr Ali Salman, Dr Ansub Mateen, Dr Atif Afzal

ABSTRACT:

Objective: It is known that good control of anemia reduces pre-operative mortality and morbidity. That is why we are investigating the effect of preoperative anemia on the result after cardiac surgery. Methods and methods: This prospective comparative observational study was held in the cardiology department of Mayo Hospital Lahore for one year duration from February 2019 to February 2020. Two hundred consecutive patients for cardiac surgery (Ischemic / valvular) aged ≥18 years were studied. All the surgeries were performed using cardiopulmonary bypass (CPB) and in hospital outcomes were recorded. Results: Of 200 patients, 140 (70%) were male and 60 (30%) were female. The mean age of the patients was 50.63 ± 15.33 years, and the mean hemoglobin level was 12.20 ± 1.98 mg / dl. Coronary artery bypass graft (CABG) patients were 132 (66%) and 68 (34%) patients who underwent valve surgery. The incidence of anemia was among 114 (57%). Preoperative anemia was associated with long-term hospitalization (CABG; 15.0 ± 6.38 vs. 7.93 ± 4.7 and valve; 17.28 ± 5.7 vs 8.65 ± 5.31), increased creatinine levels after surgery (CABG; 2.87±0.16 vs. 0.98±0.61 and valvular; 2.76±0.16 vs. 0.86±0.14) and greater blood transfusion rate (CABG;1.67±0.98 vs. 1.26±0.60 and valvular; 1.65±1.07 vs. 1.14±1.06) in cardiac surgery patients. Patients with anemia before surgery are more likely to get negative results after cardiac surgery. Postoperative wound infection (3.03% vs 2.94%), kidney damage (19.69% vs 10.29%), stroke (3.03% vs 0), postoperative MI (6%, 4.41% compared to patients with CABG) and AF (8.82% compared to 10.6 patients with valve and patients in whom preoperative anemia was again detected (4.54% vs. 14.70%) compared to CABG. Conclusion: Pre-operative anemia is associated with high hospital mortality and serious side effects in patients operated on for coronary and valvular disease. Key words: MI: myocardial infarction, CABG: coronary artery bypass, CPB: pulmonary bypass, HB: hemoglobin, BT: blood transfusion.

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