High, Low Pre-Op Blood Counts Risk Death

Older patients with high or low red-blood-cell counts before any surgery have more potentially fatal heart problems post-op, say U.S. researchers.

A team at the Providence Veterans Affairs Medical Center looked at 30-day postoperative outcomes in 310,311 veterans age 65 or older who underwent major, non-cardiac surgery between 1997 and 2004 in 132 Veterans’ hospitals around the United States.

Those who had red-blood-cell counts either lower or higher than the normal range of 39.0 to 53.9 suffered more cardiac events or died more often in the first 30 days after surgery than those whose preoperative counts were within the normal range. The farther their counts were from normal, the greater the risk.

Our findings suggest that … even minimal deviations from this optimal range were associated with an increased risk of 30-day postoperative mortality and cardiac events, the authors wrote. Future studies should determine if treatment of preoperative anemia and polycythemia (high red cell count) improve the postoperative outcomes of this vulnerable population.

The study is published in the June 13 issue of the Journal of the American Medical Association.