Open AccessEffect of Pre‐operative Anaemia on Post‐operative Complications in Low‐Resource Settings
Author(s) -
White Michelle C.,
Longstaff Lydia,
Lai Peggy S.
Publication year - 2017
Publication title -
world journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-016-3785-6
Subject(s) - medicine , odds ratio , odds , complication , logistic regression , abdominal surgery , vascular surgery , retrospective cohort study , anemia , cardiothoracic surgery , cardiac surgery , specialty , surgery , pediatrics , pathology
Background In high‐resource settings, even mild anaemia is associated with an increased risk of post‐operative complications. Whether this is true in low‐resource settings is unclear. We aimed to evaluate the effect of anaemia on surgical outcomes in the Republic of Congo and Madagascar. Method It is a retrospective chart review of 2064 non‐pregnant patients undergoing elective surgery with Mercy Ships. Logistic regression was used to determine the association between pre‐operative anaemia and pre‐defined surgical complications, adjusted for age, gender, surgical specialty, and country. Results The average age of patients was 27.2 years; 56.7% were male. Sixty‐two percent of patients were not anaemic, and 22.7, 13.9 and 1.4% met sex‐related criteria for mild, moderate and severe anaemia, respectively. In adjusted analyses, the severe anaemia group had an 8.58 [3.65, 19.49] higher odds of experiencing any surgical complication ( p < 0.001) compared to non‐anaemic patients. Analysis of each complication showed a 33.13 [9.57, 110.39] higher odds of unexpected ICU admission ( p < 0.001); a 7.29 [1.98, 21.45] higher odds of surgical site infection ( p < 0.001); and 7.48 [1.79, 25.78] higher odds of requiring hospital readmission ( p < 0.001). Evaluating other anaemia categories, only those with moderate anaemia had a higher risk of requiring ICU admission (odds ratio 2.75 [1.00, 7.04], p = 0.04) compared to those without anaemia. Conclusion Our results indicate that in low‐income settings, severe anaemia is associated with an increased risk of post‐operative complications including unexpected ICU admission, surgical site infection and hospital readmission, whereas mild anaemia was not associated with increased post‐operative complications.