EFFECT OF PREOPERATIVE HEMOGLOBIN LEVELS ON EARLY OUTCOME OF VALVE REPLACEMENT SURGERIES

Background: Preoperative anemia is associated with increased
morbidity and mortality after cardiac surgery, so we investigated
the effect of preoperative hemoglobin levels on early outcome of
valve replacement surgeries.
Aim of work: Studying the effect of preoperative hemoglobin
levels on early outcome of valve replacement surgeries.
Patients & Methods: This retrospective cross-sectional study
included (782 cases) all patients underwent open heart surgery for
valve replacement surgeries, except those with the exclusion
criteria (patients with preoperative heart failure, renal impairment,
chronic liver disease or chronic obstructive pulmonary diseases),
during a duration of 4 years from 1st of June 2013 till 31th of May
2017 in the department of cardiothoracic surgery at Zagazig
University Hospitals. Anemia was defined as hemoglobin >12.0
g/dL in women and >13.0 g/dL in men as reported by the World
Health Organization (WHO). The items we focused on during our
study were ICU stay duration, post-operative bleeding, sternal
wound infection, myocardial infarction, hospital stay duration and
in-hospital mortality.
Results: In patients undergoing open heart surgery, 22% of males
had preoperative anemia while 26% of females had preoperative
anemia. The group with preoperative anemia was associated with
increased incidence of adverse events more than the group with
normal preoperative hemoglobin levels. The concluded results
showed that: patients who suffered from prolonged ICU stay
(59.8% vs. 29.8%), post-operative bleeding (88.0% vs. 54.9%),
sternal wound infection (6.0% vs. 2.8%), myocardial infarction
(3.9% vs. 2%), prolonged hospital stay (61.5% vs. 31.8%) and inhospital
mortality (7.7% vs. 4%) among the anemic and normal
group respectively.
Conclusions: Our results indicate that preoperative anemia is
associated with a significantly increased risk of post-operative
morbidity and mortality.