Anemia Increases Mortality After Open or Endovascular Treatment in Patients with Critical Limb Ischemia: A Retrospective Analysis

Objectives Pre-operative anemia has been associated with increased post-operative morbidity and mortality in elective cardiac surgery, but its association with post-operative mortality after open or endovascular surgery for critical limb ischemia (CLI) is not well established. The aim of this study was to evaluate the relationship between pre-operative anemia and mortality in surgery for CLI. Materials and methods A retrospective study of 403 consecutive patients (mean age = 73; 73% male) undergoing open ( n  = 191, 47%) or endovascular ( n  = 212, 53%) surgery for CLI between 2005 and 2013 was performed. Neither redo revascularization procedures (ipsilateral or contralateral) nor acute limb ischemia patients were included as new cases. Results The best cut off (receiver operating characteristic curve) that related pre-operative hemoglobin to mortality was 10 g/dL. The immediate (in hospital or  p  = 0.001). The mean follow up of the cohort was 30 months (97% complete). Similarly, a pre-operative hemoglobin p Conclusions Pre-operative anemia is a risk factor for immediate and late mortality among patients with CLI, regardless of other risk factors and the type of revascularization technique. Prospective studies are needed to evaluate the potential effect of its treatment on survival outcomes.