From the Literature


Published: Oct 2019

Borderline anaemia and postoperative outcome in women undergoing major abdominal surgery: a retrospective cohort study.
Miles LF, Larsen T, Bailey MJ, Burbury KL, Story DA, Bellomo R
Anaesthesia 2019; Oct 16 [Epub ahead of print].
Pub Med
NATA rating :


M. T. Prochaska


This study aimed to test whether there were differences in outcomes of women undergoing major abdominal surgery with a preoperative Hb <13 g/dL compared to women with a Hb <12 g/dL. Compared to historical definitions of anaemia, there are now updated age-, gender-, and race-adjusted definitions, but the clinical significance of the differences in these definitions has not been well studied. The authors hypothesized that although a Hb 12-12.9 g/dL may be normal, this Hb level may not be physiologically optimal for women undergoing major abdominal surgery.

The study was a retrospective cohort study, and all women undergoing elective surgery at a single institution were included. The authors reviewed all surgeries and defined them as either “major” or “complex major” surgery. Participants were stratified according to their preoperative Hb: <12.0 g/dL, 12.0-12.9 g/dL, and ≥13.0 g/dL. The primary outcome measure was hospital length of stay.

The authors found a negative relationship between logarithmic preoperative Hb and length of stay for an Hb concentration <13.0 g/dL vs. >13.0 g/dL (P = 0.03); with a difference in length of stay approximately 50% greater for women with an Hb of 12.0 g/dL compared with those with an Hb of 13.0 g/dL.

The authors conclude that borderline anaemia increases patients’ length of stay, but the independent contribution of low Hb to perioperative outcome needs further study.

– Micah T. Prochaska (SABM reviewer)