Preoperative Hematocrit Linked with Postoperative Outcome in Older Patients

Physician's First Watch for June 13, 2007

David G. Fairchild, MD, MPH, Editor-in-Chief

Preoperative Hematocrit Linked with Postoperative Outcome in Older Patients

In older patients, preoperative hematocrit levels outside the normal range are associated with higher mortality after noncardiac surgery, a study in JAMA finds.

Researchers examined Veterans Health Administration data from some 310,000 mostly male patients aged at least 65 years who underwent major noncardiac surgery. They stratified the cohort by preoperative hematocrit level and then determined 30-day postoperative mortality.

The 30-day mortality for the entire cohort was 3.9%. Patients with preoperative anemia (hematocrit levels <39.0%)>for each percentage-point departure from the normal range.

Editorialists highlight the strengths of the large observational database used in this study, but write that clinicians should not use these findings "to justify interventions — use of transfusion, erythropoietic agents, iron supplementation — outside the research setting."


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