Abstract 11368: Pre-Procedural Hemoglobin Level Predicts Mortality in Patients Undergoing Peripheral Vascular Interventions
Background: The pre-procedural serum hemoglobin (H) level is a well known predictor of all-cause mortality in patients undergoing percutaneous coronary interventions. However, the prognostic value of pre-procedural H in patients undergoing peripheral vascular interventions (PVI) has not been studied. We sought to determine the prognostic significance of pre-procedure H in patients undergoing PVI.
Methods: We identified 346 consecutive patients undergoing PVI over a 33 month period with a pre and a post-procedural serum H level. 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. Peri-procedural H change was not associated with death (OR 1.12 [95% CI 0.71–1.79], P=NS). Logistic regression was applied for multiple variables (age, pre-procedural H, body mass index, ejection fraction, post procedural H, procedure duration, emergent vs. elective procedure, peri-procedural clinical bleed, anemia, creatinine clearance and international normalized ratio. 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 ≤ 40% (OR 1.02 [95% CI 1.01–1.05], P=0.020), and pre-procedural H (OR 1.56 [95% CI 1.19–2.04] P=0.001). Distribution of pre-procedural H level and all-cause mortality in the study population is shown in Figure 1.
Conclusions: In patients undergoing PVI, after adjusted analysis, pre-procedural H remained a significant predictor of 9 month all-cause mortality. The lowest mortality rate was seen in patients with a pre-procedural H level between 13–14 gram/dl. Pre-procedural 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 pre-procedure improves long-term mortality.
- © 2010 by American Heart Association, Inc.