Association between preoperative haemoglobin concentration and cardiopulmonary exercise variables: a multicentre study

James M Otto; Alasdair F O'Doherty; Philip J Hennis; Jackie A Cooper; Michael Pw Grocott; Chris Snowdon; John B Carlisle; Michael Swart; Toby Richards; Hugh E Montgomery

doi:10.1186/2047-0525-2-18

Association between preoperative haemoglobin concentration and cardiopulmonary exercise variables: a multicentre study

James M Otto, Alasdair F O'Doherty, Philip J Hennis, Jackie A Cooper, Michael Pw Grocott, Chris Snowdon, John B Carlisle, Michael Swart, Toby Richards, Hugh E Montgomery

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: Preoperative anaemia and low exertional oxygen uptake are both associated with greater postoperative morbidity and mortality. This study reports the association among haemoglobin concentration ([Hb]), peak oxygen uptake (V˙O2 peak) and anaerobic threshold (AT) in elective surgical patients.

METHODS: Between 1999 and 2011, preoperative [Hb] and cardiopulmonary exercise tests were recorded in 1,777 preoperative patients in four hospitals. The associations between [Hb], V˙O2 peak and AT were analysed by linear regression and covariance.

RESULTS: In 436 (24.5%) patients, [Hb] was <12 g dl-1 and, in 83 of these, <10 g dl-1. Both AT and V˙O2 peak rose modestly with increasing [Hb] (r2 = 0.24, P <0.0001 and r2 = 0.30, P <0.0001, respectively). After covariate adjustment, an increase in [Hb] of one standard deviation was associated with a 6.7 to 9.7% increase in V˙O2 peak, and a rise of 4.4 to 6.0% in AT. Haemoglobin concentration accounted for 9% and 6% of the variation in V˙O2 peak and AT respectively.

CONCLUSIONS: To a modest extent, lower haemoglobin concentrations are independently associated with lower oxygen uptake during preoperative cardiopulmonary exercise testing. It is unknown whether this association is causative.

Original language	English
Article number	18
Journal	Perioperative Medicine
Volume	2
DOIs	https://doi.org/10.1186/2047-0525-2-18
Publication status	Published - 13 Sept 2013
Externally published	Yes

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title = "Association between preoperative haemoglobin concentration and cardiopulmonary exercise variables: a multicentre study",

abstract = "BACKGROUND: Preoperative anaemia and low exertional oxygen uptake are both associated with greater postoperative morbidity and mortality. This study reports the association among haemoglobin concentration ([Hb]), peak oxygen uptake (V˙O2 peak) and anaerobic threshold (AT) in elective surgical patients.METHODS: Between 1999 and 2011, preoperative [Hb] and cardiopulmonary exercise tests were recorded in 1,777 preoperative patients in four hospitals. The associations between [Hb], V˙O2 peak and AT were analysed by linear regression and covariance.RESULTS: In 436 (24.5%) patients, [Hb] was <12 g dl-1 and, in 83 of these, <10 g dl-1. Both AT and V˙O2 peak rose modestly with increasing [Hb] (r2 = 0.24, P <0.0001 and r2 = 0.30, P <0.0001, respectively). After covariate adjustment, an increase in [Hb] of one standard deviation was associated with a 6.7 to 9.7% increase in V˙O2 peak, and a rise of 4.4 to 6.0% in AT. Haemoglobin concentration accounted for 9% and 6% of the variation in V˙O2 peak and AT respectively.CONCLUSIONS: To a modest extent, lower haemoglobin concentrations are independently associated with lower oxygen uptake during preoperative cardiopulmonary exercise testing. It is unknown whether this association is causative.",

author = "Otto, {James M} and O'Doherty, {Alasdair F} and Hennis, {Philip J} and Cooper, {Jackie A} and Grocott, {Michael Pw} and Chris Snowdon and Carlisle, {John B} and Michael Swart and Toby Richards and Montgomery, {Hugh E}",

year = "2013",

month = sep,

day = "13",

doi = "10.1186/2047-0525-2-18",

language = "English",

volume = "2",

journal = "Perioperative Medicine",

issn = "2047-0525",

publisher = "BioMed Central",

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TY - JOUR

T1 - Association between preoperative haemoglobin concentration and cardiopulmonary exercise variables

T2 - a multicentre study

AU - Otto, James M

AU - O'Doherty, Alasdair F

AU - Hennis, Philip J

AU - Cooper, Jackie A

AU - Grocott, Michael Pw

AU - Snowdon, Chris

AU - Carlisle, John B

AU - Swart, Michael

AU - Richards, Toby

AU - Montgomery, Hugh E

PY - 2013/9/13

Y1 - 2013/9/13

N2 - BACKGROUND: Preoperative anaemia and low exertional oxygen uptake are both associated with greater postoperative morbidity and mortality. This study reports the association among haemoglobin concentration ([Hb]), peak oxygen uptake (V˙O2 peak) and anaerobic threshold (AT) in elective surgical patients.METHODS: Between 1999 and 2011, preoperative [Hb] and cardiopulmonary exercise tests were recorded in 1,777 preoperative patients in four hospitals. The associations between [Hb], V˙O2 peak and AT were analysed by linear regression and covariance.RESULTS: In 436 (24.5%) patients, [Hb] was <12 g dl-1 and, in 83 of these, <10 g dl-1. Both AT and V˙O2 peak rose modestly with increasing [Hb] (r2 = 0.24, P <0.0001 and r2 = 0.30, P <0.0001, respectively). After covariate adjustment, an increase in [Hb] of one standard deviation was associated with a 6.7 to 9.7% increase in V˙O2 peak, and a rise of 4.4 to 6.0% in AT. Haemoglobin concentration accounted for 9% and 6% of the variation in V˙O2 peak and AT respectively.CONCLUSIONS: To a modest extent, lower haemoglobin concentrations are independently associated with lower oxygen uptake during preoperative cardiopulmonary exercise testing. It is unknown whether this association is causative.

AB - BACKGROUND: Preoperative anaemia and low exertional oxygen uptake are both associated with greater postoperative morbidity and mortality. This study reports the association among haemoglobin concentration ([Hb]), peak oxygen uptake (V˙O2 peak) and anaerobic threshold (AT) in elective surgical patients.METHODS: Between 1999 and 2011, preoperative [Hb] and cardiopulmonary exercise tests were recorded in 1,777 preoperative patients in four hospitals. The associations between [Hb], V˙O2 peak and AT were analysed by linear regression and covariance.RESULTS: In 436 (24.5%) patients, [Hb] was <12 g dl-1 and, in 83 of these, <10 g dl-1. Both AT and V˙O2 peak rose modestly with increasing [Hb] (r2 = 0.24, P <0.0001 and r2 = 0.30, P <0.0001, respectively). After covariate adjustment, an increase in [Hb] of one standard deviation was associated with a 6.7 to 9.7% increase in V˙O2 peak, and a rise of 4.4 to 6.0% in AT. Haemoglobin concentration accounted for 9% and 6% of the variation in V˙O2 peak and AT respectively.CONCLUSIONS: To a modest extent, lower haemoglobin concentrations are independently associated with lower oxygen uptake during preoperative cardiopulmonary exercise testing. It is unknown whether this association is causative.

U2 - 10.1186/2047-0525-2-18

DO - 10.1186/2047-0525-2-18

M3 - Article

C2 - 24472426

SN - 2047-0525

VL - 2

JO - Perioperative Medicine

JF - Perioperative Medicine

M1 - 18

ER -

Association between preoperative haemoglobin concentration and cardiopulmonary exercise variables: a multicentre study

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