Severe Anemia Linked to Higher Death Risk After Heart Surgery
THURSDAY Oct. 4, 2012 -- Anemia is a risk factor for complications and death following heart surgery, and elective heart surgeries should be delayed to treat moderate to severe anemia, a new study suggests.
In the study, Italian researchers compared the outcomes of 401 adult heart surgery patients with severe anemia and 401 heart surgery patients without severe anemia. The patients with severe anemia were nearly twice as likely to die and had a greater risk of stroke, prolonged mechanical ventilation and longer stays in the intensive care unit following surgery.
Similar results were found in patients with moderate anemia, according to the study in the October issue of The Annals of Thoracic Surgery.
"Unlike other recognized risk factors for cardiac surgery patients, such as advanced age and poor kidney function, anemia can be corrected with iron supplementation and medications that stimulate red blood cell production," lead author Dr. Marco Ranucci said in a news release from the Society of Thoracic Surgeons. "Unfortunately, to correct anemia we need two to three weeks before the operation, which may be too long for many patients to wait."
In people with anemia, the blood does not carry sufficient oxygen to the rest of the body. Blood loss, iron-poor diet or insufficient iron absorption from food all can lead to iron-deficiency anemia. Older adults are at risk for this common, easily treated anemia, the researchers noted.
Under current risk models, anemia is not considered a risk factor for survival following heart surgery, according to the release.
"Until it can be clearly demonstrated that correcting anemia improves outcomes, I think that working to correct and preserve the natural hemoglobin in a patient's blood prior to surgery is a viable and safe option," Ranucci said.
The study presents a convincing case for adding severe anemia to current models used to calculate the risks faced by heart surgery patients, Jeremiah Brown, an assistant professor at the Dartmouth Institute for Health Policy and Clinical Practice at the Geisel School of Medicine in Hanover, N.H., wrote in an accompanying journal commentary.
While the study found an association between severe anemia and post-heart surgery death risk, it did not prove a cause-and-effect relationship.
The U.S. National Heart, Lung, and Blood Institute has more about heart surgery.
Posted: October 2012
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