Amer Iqbal, Awais Alam, Tipu Khan, Javed Iqbal.
Preoperative Anemia Increases Risk of Renal Dysfunction After Coronary Artery Bypass Surgery.
J Cardiovascular Dis Jan ;17(3):130-5.

INTRODUCTION: Preoperative anemia is commonly encountered in patients undergoing coronary artery bypass surgery. It is now an established fact that anemia at the time of surgery affects the outcome. However, this fact has not been taken into account in the major cardiac surgery risk stratification systems. the impact of preoperative anemia on development of postoperative renal failure is not very well established. This study is planned to evaluate this effect. AIMS & OBJECTIVE: To assess the increases risk of renal dysfunction after Coronary Artery Bypass Surgery in patients having preoperative anemia. MATERIAL & METHODS: This is a retrospective study, data extracted from the patient record operated at our institution between Jan 2019 to Feb 2021 for isolated stable coronary artery bypass surgery. A total of 819 patients were operated,final sample size of 773 patients was selected, 185 (24%) were anemic by world health organization definition of anemia. These patients and various parameters were then compared with non-anemic patients. RESULTS: Preoperative anemia was linked with three times increased risk of developing acute kidney injury or worsening of pre-existing renal dysfunction (18.3% vs 6.4% p<0.0001). A significant difference observed in the anemic and nonanemic groups in developing post-operative stroke (2% vs 1% p=0.008), development of new onset atrial fibrillation (36.2% vs 32.9% p=0.003) and prolonged hospitalization (53.5% vs 35.8% p<0.0001). There was however no effect on post-operative myocardial infarction (2% in each group p=0.09). CONCLUSION: Preoperative anemia is a major contributor in developing renal dysfunction, stroke and atrial fibrillation after coronary artery bypass surgery.

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