Preoperative hemoglobin concentration as an independent predictor for outcome after coronary artery bypass grafting (original) (raw)

2016, Journal of the Egyptian Society of Cardio-Thoracic Surgery

Preoperative anemia is accused for increased complications, morbidity and mortality following cardiac surgery. Due to the nature of cardiac patients who usually have poor myocardium reserve and multiple concomitant comorbidities, it is difficult to identify the role of preoperative hemoglobin concentration in the postoperative outcome. Accordingly, correction of low hemoglobin level prior to cardiac surgery still is a matter of debate. Aim of the work: To determine the impact of preoperative hemoglobin concentration on postoperative outcome following coronary artery bypass grafting. Methods: Data were collected on all patients who underwent coronary artery bypass grafting surgery in our hospital in the last three years. Preoperative Anemia was defined as hemoglobin level below 12 gm. /dl. Accordingly, three groups were identified: low, normal and high preoperative hemoglobin. Postoperative bleeding, red blood cells transfused, myocardial injury, infection rate, lengths of ventilation, renal injury and length of stay in intensive care unit were recorded. Results: We recruited 804 patients in our study. Preoperative anemia were identified in 159 patients assigned in group I. Patients in this group had postoperative blood transfusion in 69% of patients and postoperative bleeding > One liter in 31.6% of patients with P-value of 0.006,0.096 respectively. It showed higher postoperative infection rate in 9.5% of patients (P-value 0.49) and higher length of stay in ICU in 43.3% of patients (P value 0.003). Group II were 481 patients, whom had HB (12.1-15 gm./dl) showed the shortest postoperative hospital stay in 56.1 % of patients, P value 0.0001. Group III, 164 patients had HB more than 15.1 gm. /dl. No cases of ICU readmission were recorded. Conclusion:-Preoperative hemoglobin level can be used as an indicator of outcome after cardiac surgery. Preoperative anemia should be optimized before coronary artery bypass grafting.