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Anemia is a common condition in surgical patients and is independently associated with increased mortality.

Wu and colleagues (2007) conducted a retrospective cohort study of consecutive male patients aged 65 years or older who underwent major noncardiac surgery during a 7-year period. Investigators observed that 30-day postoperative mortality rates increased linearly as hematocrit levels decreased. Even mild degrees of preoperative anemia or polycythemia were associated with an increased risk of 30-day postoperative mortality and cardiac events.

Two years subsequent to the study conducted by Wu et al, Beattie and colleagues demonstrated a similar relationship in noncardiac surgical patients of both sexes, noting that anemia in surgical patients is independently associated with increased mortality. As reported recently in Anesthesiology (2009), Beattie and colleagues evaluated 7759 patients undergoing noncardiac surgery in whom preoperative anemia was present. The study team found a direct association between preoperative anemia and mortality in noncardiac surgery and observed that if this association is causal, then implications are far-reaching for clinicians: correcting the anemia will likely improve patient outcomes.


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