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Preoperative hemoglobin level as a predictor of survival after coronary artery bypass grafting. A comparison with the matched general population
van Straten AHM et al. – A lower preoperative hemoglobin level is an independent predictor of late mortality in pts undergoing coronary artery bypass grafting (CABG); anemia is a risk factor for early and late mortality. Compared with the general population, anemic pts had worse survival than expected; nonanemic pts had better survival than expected.

Methods

  • Study of how the preoperative hemoglobin level affects pt survival after CABG
  • Comparison of late mortality for CABG pts vs general population
  • Determination of early and late mortality of all consecutive pts undergoing isolated CABG January 1998-December 2007
  • Classification into 4 groups stratified by preoperative hemoglobin level
  • Cutoff point for anemia: 13 g/dL men; 12 g/dL women
  • Expected survival of matched general Dutch population cohort from Dutch Central Bureau for Statistics database
  • Exclusion of 122 pts lost to follow-up and 481 with missing preoperative hemoglobin levels

Results
  • Complete data for 10,025 pts
  • On multivariate logistic regression analyses, anemia was independent risk factor for higher early mortality
  • On Cox regression analyses, low hemoglobin level, both as a continuous variable and as a dichotomous variable (anemia), was a predictor of higher late mortality
  • Compared with expected survival, pts with lowest preoperative hemoglobin levels had a worse outcome; pts with highest hemoglobin levels had better outcome
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