Lu Dai, MSc, Stephanie L. Mick, MD, Keith R. McCrae, MD, Penny L

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Presentation transcript:

Preoperative Anemia in Cardiac Operation: Does Hemoglobin Tell the Whole Story? Lu Dai, MSc, Stephanie L. Mick, MD, Keith R. McCrae, MD, Penny L. Houghtaling, MS, Joseph F. Sabik, MD, Eugene H. Blackstone, MD, Colleen G. Koch, MD, MS The Annals of Thoracic Surgery Volume 105, Issue 1, Pages 100-107 (January 2018) DOI: 10.1016/j.athoracsur.2017.06.074 Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Classification of red blood cells (RBCs) by mean corpuscular volume: normal and normocytic, microcytic, and macrocytic anemia. (fL = femtoliter.) The Annals of Thoracic Surgery 2018 105, 100-107DOI: (10.1016/j.athoracsur.2017.06.074) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Severity of preoperative anemia in elective cardiac operation. Mild anemia was defined as hemoglobin more than 11 g/dL and less than 12 g/dL for women and more than 11 g/dL and less than 13 g/dL for men; moderate as hemoglobin more than 9 g/dL and 11 g/dL or less; and severe as hemoglobin 9 g/dL or less. The Annals of Thoracic Surgery 2018 105, 100-107DOI: (10.1016/j.athoracsur.2017.06.074) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 (A) Hemoglobin and (B) mean corpuscular volume (MCV) for non-anemic patients and patients with various types of anemia. Box encompasses 25th and 75th percentiles, horizontal line within box is median, and whiskers indicate minimum and maximum values. The Annals of Thoracic Surgery 2018 105, 100-107DOI: (10.1016/j.athoracsur.2017.06.074) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Standardized differences between patients with each type of anemia and non-anemic patients. (A) Demographic characteristics. (B) Cardiac comorbidities. (C) Noncardiac comorbidities and laboratory values. (AFib = atrial fibrillation; AV = aortic valve; BMI = body mass index; BUN = blood urea nitrogen; CAD = coronary artery disease; COPD = chronic obstructive pulmonary disease; HDL = high-density lipoprotein; LDL = low-density lipoprotein; LVEF = left ventricular ejection fraction; MI = myocardial infarction; MV = mitral valve; NYHA = New York Heart Association; PAD = peripheral arterial disease; TV = tricuspid valve.) The Annals of Thoracic Surgery 2018 105, 100-107DOI: (10.1016/j.athoracsur.2017.06.074) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 (A) Odds ratios of anemic patients compared with non-anemic patients for receiving red blood cell (RBC) transfusion. Squares represent odds ratios and whiskers 95% confidence intervals. (B) Units of RBCs transfused among patients who received blood. Box encompasses 25th and 75th percentiles, horizontal line within box is median, and whiskers indicate minimum and maximum values. The Annals of Thoracic Surgery 2018 105, 100-107DOI: (10.1016/j.athoracsur.2017.06.074) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 Odds ratios, adjusted for transfusion, for adverse outcomes in patients with (A) normocytic, (B) microcytic, and (C) macrocytic anemia, compared with non-anemic patients. Squares represent odds ratios and whiskers 95% confidence intervals. The Annals of Thoracic Surgery 2018 105, 100-107DOI: (10.1016/j.athoracsur.2017.06.074) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Supplemental Figure E1 The Annals of Thoracic Surgery 2018 105, 100-107DOI: (10.1016/j.athoracsur.2017.06.074) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions