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September 2016

Preoperative Anemia and Neonates

Author Affiliations
  • 1Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
  • 2Division of Neonatology, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
  • 3Children’s Healthcare of Atlanta, Atlanta, Georgia
  • 4Pathology and Pediatrics, Emory University School of Medicine, Atlanta, Georgia
  • 5Transfusion, Tissue, and Apheresis Service, Children’s Healthcare of Atlanta, Atlanta, Georgia
JAMA Pediatr. 2016;170(9):835-836. doi:10.1001/jamapediatrics.2016.1354

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?

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