巴西一家公立医院 15 166 名手术患者的术前贫血负担和术后结果:一项回顾性队列研究。

IF 4.2 2区 医学 Q1 ANESTHESIOLOGY European Journal of Anaesthesiology Pub Date : 2024-09-24 DOI:10.1097/EJA.0000000000002070
Clarissa Mendanha, Paulo C S Neto, Rogério B Borges, Isabela Sirtoli, Cleiton S Pando, Mariana Brandão, Alexandre Weber, Leo Sekini, Luciana Cadore Stefani
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引用次数: 0

摘要

背景:术前贫血与术后不良预后有关;然而,很少有研究报告其在发展中国家的流行率及其与显著术后预后的关系:我们旨在确定巴西一家大型公立医院的贫血患病率及其与术后结果的关系:设计:回顾性队列研究:地点:巴西南部一家拥有 860 张床位的四级大学附属教学医院:我们纳入了 2015 年至 2019 年期间接受手术的成年患者。主要结果测量:主要结果是院内术后30天死亡率。根据世界卫生组织的定义,我们定义了贫血及其亚分类(轻度、中度和重度)。我们建立了泊松回归模型来研究术前贫血与结果之间的关系:我们纳入了 15 166 名患者,其中 6387 人(42.1%)贫血。在对混杂因素进行调整后,贫血患者的院内 30 天术后死亡率风险增加(相对风险 (RR) 1.69,95% 置信区间 (CI) 1.44 至 1.99,P 结论:10 例患者中有 4 例贫血:10名患者中有4名患有贫血。这些患者术后出现不良后果的风险增加。了解贫血的严重程度和影响对于在资源匮乏的情况下制定干预措施以优化患者的治疗过程至关重要:机构审查委员会注册号:40522820000005327(巴西CEP/CONEP系统,可在https://plataformabrasil.saude.gov.br/)。
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The burden of pre-operative anaemia and postoperative outcomes in 15 166 surgical patients from a public hospital in Brazil: A retrospective cohort study.

Background: Preoperative anaemia is associated with poor postoperative outcomes; however, few studies have reported its prevalence in developing countries and its association with significant postoperative outcomes.

Objective: We aimed to identify the prevalence of anaemia and its association with postoperative outcomes in a major public hospital in Brazil.

Design: Retrospective cohort study.

Setting: Single-centre, 860-bed, quaternary university-affiliated teaching hospital in Southern Brazil.

Patients: We included adult patients who had undergone surgery between 2015 and 2019. Main outcome measures: The main outcome was the in-hospital 30-day postoperative mortality. According to the World Health Organisation, we defined anaemia and its sub-classification (mild, moderate, and severe). We developed Poisson regression models to examine the association between preoperative anaemia and outcomes.

Results: We included 15 166 patients, of whom 6387 (42.1%) were anaemic. After adjustment for confounding factors, patients with anaemia had an increased risk of in-hospital 30-day postoperative mortality (relative risk (RR) 1.69, 95% confidence interval (CI) 1.44 to 1.99, P < 0.001). Mild [relative risk (RR) 1.38, 95% CI 1.12 to 1.71, P = 0.003], moderate (RR 1.73, 95% CI 1.43 to 2.10, P < 0.001), and severe anaemia (RR 2.43, 95% CI 1.92 to 3.07, P < 0.001) were associated with the primary outcome. Anaemia increased the transfusion risk (RR 4.44, 95% CI 3.90 to 5.06, P < 0.001) and postoperative intensive care unit (ICU) admission (RR 1.09, 95% CI 1.04 to 1.16, P = 0.001).

Conclusions: Four out of 10 patients had anaemia. These patients had an increased risk of adverse postoperative outcomes. Comprehension of the magnitude and impact of anaemia is essential to establish interventions in low-resource scenarios to optimise the patient's journey.

Study registration: Institutional Review Board Registration number 40522820000005327 (Brazilian CEP/CONEP System, available in https://plataformabrasil.saude.gov.br/).

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来源期刊
CiteScore
6.90
自引率
11.10%
发文量
351
审稿时长
6-12 weeks
期刊介绍: The European Journal of Anaesthesiology (EJA) publishes original work of high scientific quality in the field of anaesthesiology, pain, emergency medicine and intensive care. Preference is given to experimental work or clinical observation in man, and to laboratory work of clinical relevance. The journal also publishes commissioned reviews by an authority, editorials, invited commentaries, special articles, pro and con debates, and short reports (correspondences, case reports, short reports of clinical studies).
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