| Background: In clinical work,anemia is a common complication in critically ill patients,which has an important impact on the mortality of critically ill patients.For patients who need to undergo cardiac surgery due to various causes,the incidence of anemia is very high.Failure to timely detect and treat anemia may lead to increased risk of postoperative complications,thus affecting the prognosis of patients.Objective: To analyze the effects of preoperative anemia on postoperative oxygen delivery,mechanical ventilation time,cardiac function,blood transfusion rate,new infection rate,new kidney injury,length of stay in ICU and 30-day mortality in patients undergoing cardiac surgery,the influence of preoperative anemia on the clinical prognosis of patients undergoing cardiac surgery for the first time was determined.Method: This study was used by retrospective trial.In this study,a retrospective study was conducted,and 406 critical patients who underwent cardiac surgery and were admitted to comprehensive ICU in Linyi Central Hospital from January 1,2017 to January 1,2020 were selected.A total of 305 patients were included in this study after excluding patients younger than 18 years of age,pregnant women,patients who stayed in the ICU for less than 1 day,patients who were automatically discharged,and patients with unknown clinical data,patients who did not receive cardiac surgery for the first time,patients who received allogeneic blood transfusion within 7 days before surgery.We retrospectively analyzed the preoperative anemia,blood transfusion volume and prognosis of ICU patients with severe heart surgery for the first time.General data of the patients were collected,including basic hemoglobin level at admission,total and number of red blood cell transfusions during ICU,blood transfusion of fresh frozen plasma and platelets,postoperative oxygen delivery,invasive mechanical ventilation time,heart function(HR,NT-pro BNP),transfusion rate,infection rate,kidney injury,The length of stay in the ICU and the 30-day case fatality rate were recorded,and patients were recorded for various cardiac surgeries.To analyze the effect of preoperative anemia on prognosis of patients undergoing cardiac surgery.Data were recorded by means of mean ± standard deviation or rate for statistical analysis,and t-test or chi-square test was used for comparison between two groups,with P < 0.05 indicating statistically significant difference.Results: Among the 305 included patients,212 were non-anemia patients before surgery,and 93 were complicated with anemia before surgery,accounting for 30% of the total number of enrolled patients(P<0.05).Patients in the two groups had preoperative complications of diabetes,but there was no significant difference in general conditions(P>0.05).Postoperative oxygen delivery in anemia group was significantly lower than that in non-anemia group(394±182vs.721±284,P<0.05),heart function indexes HR and NT-pro BNP increased more significantly(779.4±300.8 vs.516.1±212.3,P<0.05).107±18vs.86±15,P<0.05),erythrocyte transfusion rate was significantly higher than that of non-anemia group(74(79.5%)vs.80(37.7%)P<0.0001).The transfusion rate of fresh frozen plasma and cryoprecipitated platelets was also higher in the anemia group.Preoperative anemia was significantly associated with the kidney injury(6(6.5%)vs 4(1.9%),p<0.05),the occurrence of new infections(7(7.5%)vs.6(2.9%),P<0.05).Also,preoperative anemia was significantly associated with invasive ventilation time(47.01±110.17 vs.23.59±52.38,P<0.05)and ICU stay(80.23±135.29 vs.50.27±71.36,P<0.05).These results suggest that preoperative anemia may lead to poor prognosis in patients undergoing cardiac surgery.Preoperative anemia does not significantly increase the 30-day mortality of patients undergoing cardiac surgery(P>0.05).Conclusion: 1.Preoperative anemia can lead to decreased oxygen delivery and prolonged invasive mechanical ventilation in patients undergoing cardiac surgery.2.Preoperative anemia can worsen postoperative cardiac function and increase the kidney injury and prolong ICU stay in patients undergoing cardiac surgery.3.Preoperative anemia can lead to increased transfusion rate and new infection rate in patients undergoing cardiac surgery.4.Preoperative anemia does not significantly increase the 30-day mortality of p atients undergoing cardiac surgery,but it tended to increase the mortality. |
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