Preoperative Anemia in Hindfoot and Ankle Arthrodesis

Dix, Brian T.; Grant-McDonald, Lisa; Catanzariti, Alan R.; Saltrick, Karl R.

doi:10.1177/1938640016666921

Cited by 9 publications

(8 citation statements)

References 21 publications

(49 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…29 A National Surgical Quality Improvement Program (NSQIP) study of 5081 patients undergoing vascular surgery showed increased mortality for both moderate (OR 2.6, 95% CI 1.2-5.5) and severe (OR 2.8, 95% CI 1.3-6.3) anemia. 30 Preoperative anemia is independently associated with early postoperative complications such as increased overall 30-day postoperative morbidity in patients under going noncardiac surgery (OR 1.35, 95% CI 1.30-1.40), 9 increased rates of major cardiac events (5.1%-6.8% v. 2.6%; p = 0.001) and acute kidney injury (52.0%-63.2% v. 31.0%; p = 0.01) in patients undergoing vascular surgery, 30,31 and increased infectious complication rates in patients undergoing orthopedic surgery (57.1% v. 6.3%; p = 0.006) 32 and those with gastric cancer (OR 3.70, 95% CI 1.43-9.58). 33 In a large NSQIP database study, preoperative anemia in patients undergoing colorectal surgery was independently associated with a significantly increased frequency of composite outcome events (myocardial infarction, acute renal injury, stroke and death) that was proportional to anemia severity (mild: OR 1.…”

Section: Preoperative Anemia Is Associated With Adverse Sur-mentioning

confidence: 99%

Clinical practice guideline: evidence, recommendations and algorithm for the preoperative optimization of anemia, hyperglycemia and smoking

Greenberg

Zwiep

Sadek

et al. 2021

cjs

View full text Add to dashboard Cite

Clinical practice guideline: evidence, recommendations and algorithm for the preoperative optimization of anemia, hyperglycemia and smoking F or most of the 20th century, the focus of research in surgery was improvements in intraoperative technique, which led to major technical paradigm shifts exemplified by the evolution of transurethral resection of the prostate, 1 laparoscopic cholecystectomy, 2 endovascular aneurysm repair 3 and total mesorectal excision for rectal cancer, 4 among many others. The late 1990s and early 2000s marked a shift in surgical research toward the evidencebased management of patients in the perioperative period, beginning with the Enhanced Recovery After Surgery Group's systematic review of patients undergoing colorectal surgery. 5 That publication introduced a new paradigm focused on the impact that standardized perioperative care could have on patient outcomes such as length of stay, postoperative pain and overall complication rates. 6,7 Although a large body of literature now exists to help guide the intraoperative and perioperative management of surgical patients, our working group believes that the preoperative period, which we define as the 8 weeks

show abstract

Section: Preoperative Anemia Is Associated With Adverse Sur-mentioning

confidence: 99%

Clinical practice guideline: evidence, recommendations and algorithm for the preoperative optimization of anemia, hyperglycemia and smoking

Greenberg

Zwiep

Sadek

et al. 2021

cjs

View full text Add to dashboard Cite

show abstract

“…In a previous study, authors found patients who received any allogeneic blood had a fourfold greater drop in nature killer cell at day 7, and also found the dose‐dependent effect on SSI 29 . Dix et al 30 demonstrated the association of preoperative anaemia with infection and the prolonged hospital stay and also the bone union issues in hindfoot and ankle arthrodesis. We suggest that blood transfusion before ankle fracture surgery repair in those with anaemia may be beneficial, but it is more reasonable to determine which population would benefit most from the blood transfusion.…”

Section: Discussionmentioning

confidence: 95%

Multiple preoperative biomarkers are associated with incidence of surgical site infection following surgeries of ankle fractures

Liu

Zhu

Chen

et al. 2020

International Wound Journal

View full text Add to dashboard Cite

The aim of the study was to investigate the epidemiologic characteristics of surgical site infection (SSI) following surgeries of ankle fractures. This was a retrospective study. Patients who underwent surgeries for ankle fractures in our hospital between January 2016 and June 2019 were included. Inpatient medical records were inquired for data collection, including demographics, comorbidities, injury‐related data, laboratory biomarkers, and confirmation of the SSI cases. Univariate analyses and multivariate logistic regression analyses were used to identify the independent risk factors. Among the 1532 patients, 45 had a postoperative SSI, indicating the incidence rate of 2.9%. About 18% of SSIs were identified after discharge. Twenty percent of SSIs were caused by mixed bacteria, and 39% were caused by drug‐resistant bacteria. In the final multivariate model, 7 factors including 5 biomarkers were identified to be independently associated with SSI: gender (male vs female, OR, 2.69; 95% CI, 1.33‐4.76), perioperative blood transfusion (OR. 3.02; 95% CI, 1.30‐7.04), albumin <35 g/L (OR, 2.87; 95% CI, 1.31‐6.31), lower high‐density lipoprotein cholesterol (HDL‐C) (OR, 2.34; 95% CI, 1.19‐4.60), haemoglobin (OR, 2.16; 95% CI, 1.03‐4.67), elevated alanine aminotransferase (OR, 2.09; 95% CI, 1.10‐3.95) and neutrophile/lymphocyte rate (NLR, OR, 3.45; 95% CI, 1.33‐6.74). These epidemiologic data on SSI may help counsel patients about the risk of SSI, individualised assessment of the risk factors, and accordingly the risk stratification.

show abstract

“…Within orthopaedic surgery, preoperative anemia has been associated with multiple adverse events including surgical site infection, periprosthetic joint infection, cardiovascular complications, increased length of hospital stay, increased incidence of transfusion, and mortality. 4,5,8,9,14,15,19,20 As opposed to most orthopaedic trauma, ankle fractures are often treated in a nonemergent manner, therefore offering the unique possibility of preoperative medical optimization. This, however, must be guided by studies delineating the outcomes associated with preoperative anemia.…”

Section: Discussionmentioning

confidence: 99%

Anemia and Its Severity Is Associated With Worse Postoperative Outcomes Following Open Reduction Internal Fixation of Ankle Fractures

et al. 2022

View full text Add to dashboard Cite

Background: Ankle fractures are often treated in a nonemergent fashion and therefore offer the chance for treatment of preoperative anemia. Although preoperative anemia has been associated with postoperative morbidity following certain types of orthopaedic procedures, its effect on postoperative outcomes following open reduction internal fixation (ORIF) of ankle fractures has not been evaluated. The purpose of this study was to determine the influence of preoperative anemia on 30-day postoperative outcomes following ankle fracture ORIF. Methods: The American College of Surgeons National Surgical Quality Improvement Program (ASC-NSQIP) registry was queried from 2005 to 2019 for patients undergoing ankle fracture ORIF. Patients were stratified into nonanemic, mildly anemic, and moderately to severely anemic. Univariate analyses were used to assess differences in patient characteristics between cohorts. Multivariate logistic regressions adjusting for these differences were performed to assess the effect of preoperative anemia on 30-day postoperative outcomes. Results: We obtained data for 21 211 patients, of whom 14 931 (70.39%) were not anemic, 3982 (18.77%) were mildly anemic, and 2298 (10.83%) were moderately to severely anemic. After adjustment, mild preoperative anemia was associated with higher odds of any adverse event ( P < .001), deep surgical site infections (SSIs; P = .013), sepsis ( P = .001), 30-day readmission ( P < .001), and extended length of stay (LOS) ( P < .001). Similarly, moderate to severe anemia in these patients was also associated with increased odds of any adverse event ( P < .001), deep SSIs ( P = .003), sepsis ( P = .001), readmission ( P < .001), and extended LOS ( P < .001). Both mild ( P = .004) and moderate to severe ( P < .001) anemia groups had higher odds of requiring a blood transfusion. Conclusion: Preoperative anemia is associated with an increased risk of adverse postoperative outcomes in patients undergoing ORIF for ankle fractures. Future studies should evaluate whether optimization of hematocrit in these patients results in improved outcomes. Level of Evidence: Level III, comparative study .

show abstract

Preoperative Anemia in Hindfoot and Ankle Arthrodesis

Abstract: Level II Study.

Cited by 9 publications

References 21 publications

Clinical practice guideline: evidence, recommendations and algorithm for the preoperative optimization of anemia, hyperglycemia and smoking

Clinical practice guideline: evidence, recommendations and algorithm for the preoperative optimization of anemia, hyperglycemia and smoking

Multiple preoperative biomarkers are associated with incidence of surgical site infection following surgeries of ankle fractures

Anemia and Its Severity Is Associated With Worse Postoperative Outcomes Following Open Reduction Internal Fixation of Ankle Fractures

Contact Info

Product

Resources

About