Department of Anesthesiology, Sakakibara Heart Institute, Tokyo, Japan.
Ann Thorac Surg. 2013 Mar;95(3):854-60. doi: 10.1016/j.athoracsur.2012.10.005. Epub 2012 Dec 6.
It is still unclear whether patients with preoperative anemia have worse outcomes after coronary artery bypass grafting (CABG) than patients without preoperative anemia. The aim of this study was to assess differences in outcomes between patients with and without preoperative anemia who underwent off-pump CABG.
A total of 1,123 patients who underwent isolated off-pump CABG between September 2004 and December 2010 were enrolled. Perioperative outcomes were compared between 254 patients with preoperative anemia (hemoglobin level: males, <12 g/dL; females, <11 g/dL) and 869 patients without preoperative anemia.
Patients with preoperative anemia were significantly older and more likely to be female than patients without preoperative anemia. Patients with preoperative anemia had higher rates of diabetes mellitus, acute coronary syndrome, and history of congestive heart failure, and had lower ejection fraction and estimated glomerular filtration rate. Patients with preoperative anemia had a higher operative death rate than patients without preoperative anemia, but this difference was not statistically significant (1.6% versus 0.3%; p = 0.0501). Univariate analysis showed that postoperative low cardiac output syndrome, hemodialysis requirement, and the composite adverse outcome were significantly higher in patients with preoperative anemia than in patients without preoperative anemia. However, multivariate analysis showed that preoperative anemia was not an independent predictor of operative death, low cardiac output, hemodialysis requirement, or the composite adverse outcome.
In patients undergoing isolated off-pump CABG, preoperative anemia was not an independent predictor of postoperative adverse events.
术前贫血的患者在接受冠状动脉旁路移植术（CABG）后是否比无术前贫血的患者预后更差仍不清楚。本研究旨在评估行非体外循环 CABG 的术前贫血和无术前贫血患者的结局差异。
共纳入 2004 年 9 月至 2010 年 12 月期间行单纯非体外循环 CABG 的 1123 例患者。比较了 254 例术前贫血患者（血红蛋白水平：男性，<12 g/dL；女性，<11 g/dL）和 869 例无术前贫血患者的围手术期结局。
术前贫血患者明显比无术前贫血患者年龄更大，且更可能为女性。术前贫血患者糖尿病、急性冠状动脉综合征和充血性心力衰竭病史的发生率更高，射血分数和估算肾小球滤过率更低。术前贫血患者的手术死亡率高于无术前贫血患者，但差异无统计学意义（1.6%比 0.3%；p = 0.0501）。单因素分析显示，术前贫血患者术后低心输出量综合征、需要血液透析和复合不良结局的发生率明显高于无术前贫血患者。然而，多因素分析显示术前贫血不是手术死亡、低心输出量、需要血液透析或复合不良结局的独立预测因素。
在接受单纯非体外循环 CABG 的患者中，术前贫血不是术后不良事件的独立预测因素。
