Impact of Preoperative Anemia on Postoperative Outcomes in General Surgery and Gynecology patients

Abstract

Background: Anemia is a common clinical condition in surgical patients and can decrease tissue oxygen delivery, increase perioperative transfusion needs and negatively impact postoperative recovery. This investigation evaluated the effects of preoperative anemia on the postoperative results of patients who underwent general surgical and gynecological operations.

Methods: This prospective comparative observational study was conducted at Qazi Hussain Ahmad Medical Complex, Nowshera, and Timergara Medical College and DHQ Teaching Hospital from March 2023 to August 2023. Patients were randomly selected by consecutive sampling for total 82 patients undergoing general surgical or gynecological procedure were recruited. Patients were divided into two groups: an anemic group (preoperative hemoglobin level < 12 g/dl) and a non-anemic group (preoperative hemoglobin level ≥ 12 g/dl). Demographic, clinical, hematological, operative and postoperative data were recorded. Appropriate statistical tests were used to compare outcomes, and multivariable logistic regression to determine the independent predictors of postoperative complications. A p value < 0.05 was deemed as significant.

Results: Preoperative anemia was identified in 34 (41.5%) patients, while 48 (58.5%) had normal hemoglobin levels. Overall postoperative complications occurred more frequently among anemic than non-anemic patients (52.9% versus 20.8%, p = 0.003). Anemic patients had higher rates of postoperative blood transfusion (41.2% versus 10.4%, p = 0.001) and prolonged hospitalization (44.1% versus 16.7%, p = 0.006). Their mean hospital stay was also longer (6.8 ± 3.1 versus 4.2 ± 2.0 days, p < 0.001). Moderate or severe anemia was associated with poorer outcomes than mild anemia. After adjustment for potential confounders, preoperative anemia remained an independent predictor of postoperative complications (adjusted OR: 3.61; 95% CI: 1.25–10.41; p = 0.018).

Conclusion: Preoperative anemia was common and was independently associated with increased postoperative complications, blood transfusion requirements, and prolonged hospitalization. Early detection, investigation, and appropriate management of anemia before surgery may improve postoperative recovery and reduce perioperative morbidity.

Keywords: Preoperative anemia; postoperative complications; blood transfusion; general surgery; gynecology; length of hospital stay.