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dc.contributor.authorMyles, Paul S-
dc.contributor.authorRichards, Toby-
dc.contributor.authorKlein, Andrew-
dc.contributor.authorWood, Erica M-
dc.contributor.authorWallace, Sophie-
dc.contributor.authorShulman, Mark A-
dc.contributor.authorMartin, Catherine-
dc.contributor.authorBellomo, Rinaldo-
dc.contributor.authorCorcoran, Tomás B-
dc.contributor.authorPeyton, Philip J-
dc.contributor.authorStory, David A-
dc.contributor.authorLeslie, Kate-
dc.contributor.authorForbes, Andrew-
dc.identifier.citationBritish Journal of Anaesthesia 2022; 129(3): 346-354en
dc.description.abstractCompared with anaemia before surgery, the underlying pathogenesis and implications of postoperative anaemia are largely unknown. This retrospective cohort study analysed prospective data obtained from 2983 adult patients across 47 centres enrolled in a clinical trial evaluating restrictive and liberal intravenous fluids. The primary endpoint was persistent disability or death up to 90 days after surgery. Secondary endpoints included major septic complications, hospital stay, and patient quality of recovery using a 15-item quality of recovery (QoR-15) score, hospital re-admissions, and disability-free survival up to 12 months after surgery. Anaemia and disability were defined according to the WHO definitions. Multivariable regression was used to adjust for baseline risk and surgery. A total of 2983 patients met inclusion criteria for this study, of which 78.5% (95% confidence interval [CI], 76.7-80.1%) had postoperative anaemia. Patients with postoperative anaemia had a higher adjusted risk of death or disability up to 90 days after surgery when compared with those without anaemia: 18.2% vs 9.2% (risk ratio [RR]=1.51; 95% CI, 1.10-2.07, P=0.011); lower QoR-15 scores on Day 3 and Day 30, 105 (95% CI, 87-119) vs 114 (95% CI, 99-128; P<0.001), and 130 (95% CI, 112-140) vs 139 (95% CI, 121-144; P<0.011), respectively; higher adjusted risk of a composite of mortality/septic complications, 2.01 (95% CI, 1.55-42.67; P<0.001); unplanned admission to ICU (RR=2.65; 95% CI, 1.65-4.23; P<0.001); and longer median (inter-quartile range [IQR]) hospital stays, 6.6 (4.4-12.4) vs 3.7 (2.5-6.5) days (P<0.001). Postoperative anaemia is common and is independently associated with poor outcomes after surgery. Optimal prevention and treatment strategies need to be investigated. NCT04978285 (
dc.subjectabdominal surgeryen
dc.titlePostoperative anaemia and patient-centred outcomes after major abdominal surgery: a retrospective cohort study.en
dc.typeJournal Articleen
dc.identifier.journaltitleBritish Journal of Anaesthesiaen
dc.identifier.affiliationDepartment of Haematology, Monash Health, Clayton, Victoria, Australia..en
dc.identifier.affiliationIntensive Careen
dc.identifier.affiliationDepartment of Surgery, University of Western Australia, Perth, Australia..en
dc.identifier.affiliationTransfusion Research Unit, Monash University, Melbourne, Victoria, Australia..en
dc.identifier.affiliationDepartment of Critical Care, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia..en
dc.identifier.affiliationDepartment of Anaesthesiology and Perioperative Medicine, Central Clinical School, Australia..en
dc.identifier.affiliationDepartment of Anaesthesia and Pain Management, Royal Melbourne Hospital, Parkville, Victoria, Australia..en
dc.identifier.affiliationDepartment of Anaesthesia and Pain Medicine, Royal Perth Hospital, Perth, Western Australia, Australia..en
dc.identifier.affiliationBiostatistics Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia..en
dc.identifier.affiliationDepartment of Anaesthesiology and Perioperative Medicine, Alfred Hospital, Melbourne, Victoria, Australia..en
dc.identifier.affiliationDepartment of Anaesthesia, Papworth Hospital, Cambridge, UK..en
dc.identifier.pubmedid35843746, Rinaldo
item.fulltextNo Fulltext-
item.openairetypeJournal Article-
item.openairecristype Care- Analytics Research and Evaluation (DARE) Centre- for Breathing and Sleep-
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