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Published on: September 22, 2020
Preprocedural hemoglobin predicts mortality following peripheral vascular interventions
Zehra Jaffery1, Lior Shamai, Christopher J White
1Department of Cardiology, John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, Louisiana 70120, USA. zjaffery@ochsner.org
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.
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