4.4 Article

Preoperative anemia and surgical outcomes following laparotomy in a resource-limited setting

Journal

AMERICAN JOURNAL OF SURGERY
Volume 222, Issue 2, Pages 424-430

Publisher

EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjsurg.2020.12.032

Keywords

Anemia; Preoperative anemia; Laparotomy; Post-operative complications; Resource-limited settings

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Funding

  1. Fogarty International Center, National Institutes of Health [D43TW009340]

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The study found that preoperative anemia increases the risk of post laparotomy abdominal complications, indicating that anemia is a significant modifiable factor that needs attention.
Introduction: Anemia is a common and potentially modifiable condition in sub-Saharan Africa. We sought to determine the role of preoperative anemia on post laparotomy abdominal complications. Methods: We conducted a six-month prospective, observational study of patients age >12 years following laparotomy at a tertiary hospital in Malawi. The outcome was the occurrence of abdominal complications. Poisson regression analyses estimated the risk of abdominal complications in patients with moderate/severe anemia. Results: Of 280 patients, most were male (76.4%) with median age of 35 years (IQR 24-50). Abdominal complications developed in 34 patients (15.2%). Of the 224 patients with known preoperative hemoglobin 54 (20.7%) were moderately or severely anemic at the time of surgery. Patients with moderate-to-severe anemia had an increased risk of abdominal complications (RR 4.44, 95% CI 2.0-9.6). Conclusion: Anemia is a common but modifiable comorbidity among laparotomy patients and independently increases the risk of abdominal complications. (C) 2020 Elsevier Inc. All rights reserved.

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