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Hematocrit Level and Postsurgical OutcomePowers of Observation
Farhood Farjah, MD;
David R. Flum, MD, MPH
JAMA. 2007;297:2525-2526.
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In this issue of JAMA, Wu and colleagues1 report the results of a cohort study examining the relationship between preoperative hematocrit levels and adverse events among older veterans (most of whom were men) undergoing noncardiac surgery. Incremental departures less than or greater than normal hematocrit levels for mostly men were associated with increased risk of early death and postoperative cardiac events. The authors recommend future studies to evaluate interventions aimed at reducing the risk of postsurgical events attributable to either anemia or polycythemia.
This work highlights the strengths of using high-quality, large observational databases—such as the Veterans Affairs (VA) National Surgical Quality Improvement Program (NSQIP)—to explore the relationship between patient factors and adverse outcomes. A large sample size allowed for adjustment of many potentially confounding variables that are common to surgical practice. Moreover, the sample size augments natural strengths of a . . . [Full Text of this Article]
Author Affiliations: Department of Surgery, University of Washington, Seattle. Dr Flum is Contributing Editor, JAMA.
RELATED ARTICLE
Preoperative Hematocrit Levels and Postoperative Outcomes in Older Patients Undergoing Noncardiac Surgery
Wen-Chih Wu, Tracy L. Schifftner, William G. Henderson, Charles B. Eaton, Roy M. Poses, Georgette Uttley, Satish C. Sharma, Michael Vezeridis, Shukri F. Khuri, and Peter D. Friedmann
JAMA. 2007;297(22):2481-2488.
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