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To the Editor: Dr Wu and colleagues¹ reported the results of a large retrospective cohort study to determine the prevalence of abnormal preoperative hematocrit levels and the association of this abnormality with postoperative mortality and cardiac events in elderly patients undergoing noncardiac surgery. They demonstrated a negative association with both low and high preoperative hematocrit levels.

The correlation between low preoperative hematocrit and these outcomes is supported by the established association between anemia and cardiac events.² More controversial is the association between polycythemia and postoperative outcome. An association between polycythemia and thrombosis has been shown,³ but in the absence of intraoperative blood transfusions for these patients, it is likely that hematocrit levels after surgery would be decreased. Furthermore, patients undergoing surgery usually receive thromboprophylaxis.⁴ These 2 conditions should at least partially protect patients with polycythemia from thrombotic events.

In a study of hemoglobin variation in women undergoing chemotherapy followed by . . . [Full Text of this Article]

Filippo Bellati, MD
filippo.bellati@uniroma1.it

Francesco Plotti, MD; Pierluigi Benedetti Panici, MD
Department of Obstetrics and Gynecology
University of Rome La Sapienza
Rome, Italy

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Preoperative Hematocrit Levels and Outcomes After Noncardiac Surgery
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Preoperative Hematocrit Levels and Outcomes After Noncardiac Surgery—Reply
Wen-Chih Wu, Tracy L. Schifftner, and William G. Henderson
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Preoperative Hematocrit Levels and Postoperative Outcomes in Older Patients Undergoing Noncardiac Surgery
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