Association between preoperative haemoglobin concentration and cardiopulmonary exercise variables: a multicentre study

Perioperative Medicine

Hugh E Montgomery⁵  Toby Richards²  Michael Swart⁶  John B Carlisle⁶  Chris Snowdon³  Michael PW Grocott⁴  Jackie A Cooper¹  Philip J Hennis⁷  Alasdair F O’Doherty⁷  James M Otto⁷ 

[1] Department of Medicine, Centre of Cardiovascular Genetics, University College London, 5 University Street, London WC1E 6JF, UK;Division of Surgery and Interventional Science, University College London, 21 University Street, London WC1E 6DE, UK;Newcastle Upon Tyne NHS Foundation Trust, Freeman Hospital, Freeman Road, High Heaton, Newcastle Upon Tyne NE7 7DN, UK;Integrative Physiology and Critical Illness Group, Division of Clinical and Experimental Science, Faculty of Medicine, University of Southampton, University Road, Southampton SO17 1BJ, UK;UCL Institute for Human Health and Performance, c/o 4th Floor, Rockefeller Building, 21 University Street, London WC1E 6DE, UK;Torbay Hospital, South Devon Healthcare NHS Foundation Trust, Torbay Hospital, Lawes Bridge, Torquay TQ2 7AA, UK;The Portex Unit, UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK

关键词: Surgery;    Oxygen uptake;    Haemoglobin concentration;    CPET;    Cardiopulmonary exercise testing;    Anaemia;   

Others  :  816371
DOI  :  10.1186/2047-0525-2-18

 received in 2013-05-13, accepted in 2013-09-02,  发布年份 2013

【 摘 要 】

Background

Preoperative anaemia and low exertional oxygen uptake are both associated with greater postoperative morbidity and mortality. This study reports the association among haemoglobin concentration ([Hb]), peak oxygen uptake (View MathML"> peak) and anaerobic threshold (AT) in elective surgical patients.

Methods

Between 1999 and 2011, preoperative [Hb] and cardiopulmonary exercise tests were recorded in 1,777 preoperative patients in four hospitals. The associations between [Hb], View MathML"> peak and AT were analysed by linear regression and covariance.

Results

In 436 (24.5%) patients, [Hb] was <12 g dl^-1 and, in 83 of these, <10 g dl^-1. Both AT and View MathML"> peak rose modestly with increasing [Hb] (r² = 0.24, P <0.0001 and r² = 0.30, P <0.0001, respectively). After covariate adjustment, an increase in [Hb] of one standard deviation was associated with a 6.7 to 9.7% increase in View MathML"> peak, and a rise of 4.4 to 6.0% in AT. Haemoglobin concentration accounted for 9% and 6% of the variation in View MathML"> peak and AT respectively.

Conclusions

To a modest extent, lower haemoglobin concentrations are independently associated with lower oxygen uptake during preoperative cardiopulmonary exercise testing. It is unknown whether this association is causative.

【 授权许可】

   
2013 Otto et al.; licensee BioMed Central Ltd.

【 图 表 】

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