The effects of preoperative haemoglobin levels on early morbidity and mortality in patients undergoing isolated aortic valve replacement

Rauf Önder, Salih Özçobanoğlu, İsmail Kakillioğlu, Veli Burak Taşkın, Bengi Polen Gündoğdu

Abstract

Objective: This study aimed to evaluate the impact of preoperative haemoglobin levels on early morbidity and mortality in patients undergoing isolated aortic valve replacement.
Material and methods: This retrospective study included 149 patients who underwent aortic valve replacement at Akdeniz University between 2013 and 2023. Patients were categorised as anaemic or non-anaemic based on the World Health Organisation (WHO) definition. Preoperative characteristics, intraoperative parameters, and postoperative outcomes were compared. Statistical analyses were performed using SPSS 27.0, with significance set at p < 0.05.
Results: Anaemic patients were significantly older (62.8 ± 12.7 vs. 56.3 ± 18.3 years, p = 0.01) and had lower body surface area (1.84 ± 0.20 vs. 1.92 ± 0.24 m², p = 0.026). Aortic root diameter was smaller in the anaemic group (29.2 ± 3.7 mm vs. 31.2 ± 3.9 mm, p = 0.001). Prior cardiac surgery was more common in anaemic patients (23.1% vs. 9.1%, p = 0.025). Intraoperative blood transfusion (p < 0.001) and extubation time (p < 0.001) were significantly higher in anaemic patients. Postoperatively, renal failure (p = 0.010) and sepsis (p = 0.030) were more frequent. In-hospital mortality was higher in anaemic patients (10.3% vs. 1.4%), and this difference was statistically significant (p = 0.024). ICU length of stay was found to be significantly longer in anaemic patients (6.1 ± 10.9 days vs. 3.5 ± 2.1 days, p = 0.005).
Conclusion: Preoperative anaemia was associated with increased postoperative morbidity and in-hospital mortality. Haemoglobin level emerged as an independent predictor of mortality, underscoring the importance of preoperative haemoglobin optimisation to improve surgical outcomes.