Preprocedural hemoglobin predicts mortality following peripheral vascular interventions

Catheter Cardiovasc Interv. 2011 Oct 1;78(4):599-603. doi: 10.1002/ccd.23065. Epub 2011 Jul 29.

Abstract

Background: Serum hemoglobin (H) level is a well-known predictor of all-cause mortality in patients undergoing percutaneous coronary interventions but has not been studied in patients undergoing peripheral vascular interventions (PVI). We sought to determine the prognostic significance of serum H in patients undergoing PVI.

Methods: We identified 346 consecutive patients undergoing PVI who had a documented a baseline and a postprocedural serum H level over a 33-month period. A multivariate analysis of predictors of 9-month mortality was performed.

Results: Of 346 patients identified, there were 28 deaths (8.1%) over a 9-month follow-up period. Periprocedural H change was not associated with death [OR: 1.12 (95% CI: 0.71-1.79), P = NS]. In a multivariate model independent predictors of all-cause mortality were clinical bleeding [OR: 10.7 (95% CI: 0.012-0.769), P = 0.026], emergency intervention [OR: 4.5 (95% CI: 0.07-0.71), P = 0.011], ejection fraction [OR: 1.02 (95% CI: 1.01-1.05), P = 0.020], and preprocedural H [OR: 1.56 (95% CI: 1.19-2.04) P = 0.001].

Conclusion: In patients undergoing PVI, preprocedural H was a significant predictor of 9-month all-cause mortality. The highest mortality rate was seen in patients with a preprocedural H level ≤ 10 g/dl. Preprocedural H level can be used in clinical practice to risk stratify patients being considered for PVI. Further investigation is needed to assess if optimization of H level preprocedure improves midterm mortality.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Chi-Square Distribution
  • Down-Regulation
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / mortality*
  • Female
  • Hemoglobins / analysis*
  • Humans
  • Logistic Models
  • Louisiana
  • Male
  • Middle Aged
  • Odds Ratio
  • Peripheral Vascular Diseases / blood
  • Peripheral Vascular Diseases / mortality
  • Peripheral Vascular Diseases / therapy*
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome

Substances

  • Biomarkers
  • Hemoglobins