Preoperative anaemia and red blood cell transfusion in patients with aneurysmal subarachnoid and intracerebral haemorrhage - a multicentre subanalysis of the German PBM Network Registry.

Eva Herrmann, Florian Piekarski, Kai Zacharowski, Christoph Wiesenack, Henry Weigt, Markus Velten, Josef Thoma, Andrea U Steinbicker, Patrick Stark, Erhard Seifried, Klaus Schwendner, Ansgar Raadts, Diana Narita, Markus Müller, Suma Choorapoikayil, Philipp Helmer, Martin Gutjahr, Matthias Grünewald, Christof Geisen, Jens Friedrich, Patrick Friederich, Alexandra Bayer, Peter Baumgarten, Vanessa Neef, Patrick Meybohm, Elke Schmitt, Maria Wittmann, Erdem Güresir

Journal: Acta neurochirurgica 2022;164(4):985-999

PMID: 35220460

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Abstract

PURPOSE

Anaemia is common in patients presenting with aneurysmal subarachnoid (aSAH) and intracerebral haemorrhage (ICH). In surgical patients, anaemia was identified as an idenpendent risk factor for postoperative mortality, prolonged hospital length of stay (LOS) and increased risk of red blood cell (RBC) transfusion. This multicentre cohort observation study describes the incidence and effects of preoperative anaemia in this critical patient collective for a 10-year period.

METHODS

This multicentre observational study included adult in-hospital surgical patients diagnosed with aSAH or ICH of 21 German hospitals (discharged from 1 January 2010 to 30 September 2020). Descriptive, univariate and multivariate analyses were performed to investigate the incidence and association of preoperative anaemia with RBC transfusion, in-hospital mortality and postoperative complications in patients with aSAH and ICH.

RESULTS

A total of n = 9081 patients were analysed (aSAH n = 5008; ICH n = 4073). Preoperative anaemia was present at 28.3% in aSAH and 40.9% in ICH. RBC transfusion rates were 29.9% in aSAH and 29.3% in ICH. Multivariate analysis revealed that preoperative anaemia is associated with a higher risk for RBC transfusion (OR = 3.25 in aSAH, OR = 4.16 in ICH, p < 0.001), for in-hospital mortality (OR = 1.48 in aSAH, OR = 1.53 in ICH, p < 0.001) and for several postoperative complications.

CONCLUSIONS

Preoperative anaemia is associated with increased RBC transfusion rates, in-hospital mortality and postoperative complications in patients with aSAH and ICH.

TRIAL REGISTRATION

ClinicalTrials.gov , NCT02147795, https://clinicaltrials.gov/ct2/show/NCT02147795.

Address: Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.; Institute of Biostatistics and Mathematical Modelling, Department of Medicine, Goethe University, Frankfurt, Germany.; Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany. [email protected].; Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wuerzburg, Wuerzburg, Germany. [email protected].; Department of Neurosurgery, University Hospital Frankfurt, Frankfurt am Main, Germany.; Department of Neurosurgery, University Hospital, Schiller University Jena, Jena, Germany.; Department of Anesthesiology and Intensive Care Medicine, Krankenhaus Agatharied, Hausham, Academic Teaching Hospital of the Ludwig-Maximilians University of Munich, Munich, Germany.; Department of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, München Klinik Bogenhausen, Munich, Germany.; Department of Anesthesiology and Operative Intensive Care Medicine, Klinikum Leverkusen, Leverkusen, Germany.; German Red Cross, Institute for Transfusion Medicine and Immunohematology, German Red Cross Baden-Wuertemberg - Hessen, Goethe University Frankfurt, Frankfurt am Main, Germany.; Department of Neurosurgery, University Hospital Bonn, Bonn, Germany.; Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Kiel, Germany.; Department of Anesthesiology, Marienhaus Klinikum St. Wendel-Ottweiler, Ottweiler, Germany.; Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wuerzburg, Wuerzburg, Germany.; Institute for Laboratory Diagnostics and Transfusion Medicine, DonauIsar Klinikum, Deggendorf/Dingolfing/Landau, Germany.; Department of Anesthesiology and Intensive Care Medicine, University Hospital Jena, Jena, Germany.; Department of Anesthesiology and Operative Intensive Care Medicine, Diakonie hospital Martha-Maria, Nuremberg, Germany.; Department of Vascular Surgery, Katholisches Klinikum Koblenz, Koblenz, Germany.; Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Muenster, Germany.; Department of Anesthesiology and Operative Intensive Care Medicine, Ortenau Klinikum Offenburg-Kehl, Offenburg, Germany.; Department of Anaesthesiology and Operative Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.; Department of Anesthesiology, SLK-Kliniken, Heilbronn, Germany.; Department of Anesthesiology, Protestant Deaconess Hospital Freiburg, Freiburg, Germany.; Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany. [email protected].

DOI: 10.1007/s00701-022-05144-7

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https://dx.doi.org/10.1007/s00701-022-05144-7

MeSH Terms: Adult, Anemia, Cerebral Hemorrhage, Erythrocyte Transfusion, Humans, Registries, Streptothricins, Subarachnoid Hemorrhage