Izvorni znanstveni članak
https://doi.org/10.3325/cmj.2025.66.186
Preoperative polycythemia may be associated with inferior postoperative outcomes: a retrospective study
Ivan Krečak
; Department of Internal Medicine, General Hospial of Šibenik Knin County, Šibenik, Croatia
*
Marija Valovičić Krečak
; Department for Quality Assurance and Improvement of Health Care, General Hospital of Šibenik-Knin County, Šibenik, Croatia
Iva Lazinica
; Department of Internal Medicine, General Hospial of Šibenik Knin County, Šibenik, Croatia
Marko Lucijanić
; Department of Hematology, Dubrava University Hospital, Zagreb, Croatia
* Dopisni autor.
Sažetak
Aim To investigate the influence of preoperative poly
cythemia on postoperative outcomes.
Methods We retrospectively reviewed the postoperative
outcomes of 1196 elective non-cardiac surgery procedures
(minor, 36%; intermediate/major, 64%) performed under
general anesthesia at the General Hospital of Šibenik-Knin
County, Croatia, between January 1, 2023 and January 1,
2024. Patients were stratified preoperatively as having ane
mia, normal hemoglobin, or polycythemia. The primary
outcome was a 30-day postoperative composite outcome
consisting of death, thrombosis, major bleeding, and the
need for red blood cell transfusion.
Results Anemia, normal hemoglobin levels, and poly
cythemia were recorded preoperatively in 152 (12.7%),
1000 (83.6%), and 44 (3.7%) of patients, respectively. Pa
tients with polycythemia were the youngest, more fre
quently men and smokers, and had the lowest frequency
of prior venous thromboembolism (VTE). Patients with
anemia were the oldest and most frequently had comor
bidities, cancer, and prior VTE, used anticoagulants, and
underwent intermediate/major surgeries. The composite
outcome was recorded in 91 procedures (7.6%) and was
most frequent in patients with polycythemia (18.2% vs
9.2% vs 6.9%; P = 0.016). Patients with polycythemia also
most frequently had postoperative bleeding (18.2% vs
7.9% vs 6.5%; P = 0.011) and did not need postoperative
red blood cell transfusions (P = 0.003). The associations of
preoperative polycythemia with the postoperative com
posite outcome and bleeding remained significant in mul
tivariate models adjusted for surgery risk, sex, comorbidi
ties, physical status, and antiplatelet or anticoagulant use.
Patients with polycythemia did not experience deaths or
thrombotic events.
Conclusion Patients with polycythemia require compre
hensive preoperative assessment. Future studies are need
ed to investigate the pathophysiological mechanisms un
derlying the observed effects.
Ključne riječi
Hrčak ID:
352487
URI
Datum izdavanja:
25.6.2025.
Posjeta: 0 *