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

Sport Exercise and Rehabilitation Department

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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
Pages (from-to)	18
Journal	Perioperative Medicine
Volume	2
Issue number	1
DOIs	https://doi.org/10.1186/2047-0525-2-18
Publication status	Published - 13 Sept 2013

Keywords

Anaemia
Cardiopulmonary exercise testing
CPET
Haemoglobin concentration
Oxygen uptake
Surgery

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10.1186/2047-0525-2-18Licence: Other

Perioperative medicineFinal published version, 562 KBLicence: Other

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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.",

keywords = "Anaemia, Cardiopulmonary exercise testing, CPET, Haemoglobin concentration, Oxygen uptake, Surgery",

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}",

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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.

KW - Anaemia

KW - Cardiopulmonary exercise testing

KW - CPET

KW - Haemoglobin concentration

KW - Oxygen uptake

KW - Surgery

U2 - 10.1186/2047-0525-2-18

DO - 10.1186/2047-0525-2-18

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SN - 2047-0525

VL - 2

SP - 18

JO - Perioperative Medicine

JF - Perioperative Medicine

IS - 1

ER -

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

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