Anaemia in patients who underwent vascular surgery: a significant predictor of amputation and death

Med Clin (Barc) . 2019 Jan 4;152(1):6-12. doi: 10.1016/j.medcli.2018.01.029. Epub 2018 Apr 9.

Fecha de la publicación: 09/04/2018

Autor: Carlos Esteban (1), Patricia Rodríguez (2), José Román Escudero (3), Albert Clarà (4), Alvaro Fernández (5), Sebastián Fernández (6), Ignacio Agúndez (7)

Palabras clave: Anaemia, Anemia, Enfermedad arterial periférica, Peripheral arterial disease



1Servicio de Angiología y Cirugía Vascular, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España. Electronic address:

2Servicio de Angiología y Cirugía Vascular, Hospital Josep Trueta, Gerona, España.

3Servicio de Angiología y Cirugía Vascular, Hospital de la Santa Creu i Sant Pau, Barcelona, España.

4Servicio de Angiología y Cirugía Vascular, Hospital del Mar, Barcelona, España.

5Servicio de Angiología y Cirugía Vascular, Hospital La Paz, Madrid, España.

6Servicio de Angiología y Cirugía Vascular, Complejo Hospitalario de Navarra, Pamplona, Navarra, España.

7Servicio de Angiología y Cirugía Vascular, Hospital Universitario de Burgos, Burgos, España.


Background and objective: In patients with peripheral artery disease requiring surgery, anaemia has been found to independently predict short and medium term higher morbidity and mortality.

Patients and methods: We retrospectively studied all patients undergoing surgery, consecutively during 2months in 12 vascular surgery units. We analysed cardiovascular risk factors and preoperative haemoglobin. Statistical analysis was done with Kaplan-Meier for survival and logistic regression modelling to identify predictors of mortality.

Results: 518 patients were consecutively operated on in our vascular units, the mortality rate was 21% the first year and 34% for cardiovascular events. Preoperative anaemia was present in 63% of the ischemic patients and in 23% of the patients requiring aneurysm repair, one year after surgery it increased to 68% and 50% respectively. When preoperative anaemia was superior to 10mg/dl, one year survival increased (96% vs. 90%), fewer cardiovascular events occurred and there were fewer amputations (24% vs. 68%).

Conclusions: On multivariable analysis: age, renal failure, chronic lung disease, coronary artery disease, postoperative complications and previous cardiovascular events were associated with an increased risk mortality rate. Preoperative haemoglobin influenced proportionally such that for every 1mg /dl increase, the probability of mortality decreases by 0.81. Preoperative anaemia, especially when haemoglobin is inferior to 10mg/dl, is associated with an increased risk of death and amputation.