In this issue, Goobie et al1 describe an independent association of preoperative anemia, defined as a hematocrit level less than 40%, with higher in-hospital mortality in neonates. Preoperative anemia was 1 of several independent risk factors associated with postoperative mortality; the others were American Society of Anesthesiologists class 3 to 5, body weight less than 2 kg, preoperative mechanical ventilation, and preoperative inotropic support. With almost two-thirds of the procedures being classified as emergent, the factors associated with mortality, with the exception of anemia, are largely not modifiable prior to surgery. The question then remains: if the anemia was corrected prior to surgery, would the outcome be improved with respect to the mortality rate?
Higgins RD, Patel RM, Josephson CD. Preoperative Anemia and Neonates. JAMA Pediatr. 2016;170(9):835-836. doi:10.1001/jamapediatrics.2016.1354