Impacto de la anemia preoperatoria en la revascularización de pacientes con isquemia crítica de la extremidad inferior

Résumé

Introduction. Preoperative anemia is an established risk factor for cardiovascular disease and surgical procedures; however, has not yet been convincingly established its role in peripheral vascular surgery. This paper evaluates the impact of preoperative anemia in patients undergoing revascularization for critical limb ischemia. Material and Methods. A retrospective observational study of patients who underwent revascularization for critical limb ischemia in the University Hospital of Valladolid was designed. We classified patients into two groups according to the preoperative hemoglobin value, setting the cut-off point at 10 g / dL. Both groups were compared to estimate differences in major amputation, exitus, major amputation free survival, hospital stay and complications. Results. Of the 672 patients included in the study, 66 (9.9%) had a hemoglobin level below 10 g /dL. The group of anemic patients had higher 30-day (13.6% versus 5.4%) and one year (42.6% versus 14.7%) mortality; major amputation rate was also significantly worse after 30 days (21.2% vs. 8.3%) and a year (36.4% versus 20.7%). The major amputation-free survival was worse in anemic patients (68%, 62%, 56%, 50% and 47% versus 38%, 31%, 31%, 25% and 25% at 1, 2, 3, 4 and 5 years). Also, the average stay was higher in anemic patients (20.09 versus 14.96 19.38 +/-12.03 days). Conclusion. Preoperative anemia in patients who undergo revascularization for critical lower limb ischemia is associated with worse clinical outcome in terms of death and amputation, both short and long term as well as a higher rate of cardiorespiratory complications.