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Background —The predictive value of the preoperative hemoglobin value after coronary artery bypass grafting (CABG)
has not been well established. We studied how the preoperative hemoglobin level affects the survival of patients after
CABG. Late mortality was compared with that of a general population.
Methods and Results —Early and late mortality of all consecutive patients undergoing isolated CABG between January
1998 and December 2007 were determined. Patients were classified into 4 groups stratified by preoperative hemoglobin
level. The cutoff point for anemia was 13 g/dL for men and 12 g/dL for women. Expected survival of a matched general
Dutch population cohort was obtained from the database of the Dutch Central Bureau for Statistics. After the exclusion
of 122 patients who were lost to follow-up and 481 patients with missing preoperative hemoglobin levels, complete data
were obtained in 10 025 patients. Multivariate logistic regression analyses revealed anemia to be an independent risk
factor for higher early mortality. Cox regression analyses revealed low hemoglobin level, both as a continuous variable
and as a dichotomous variable (anemia), to be a predictor of higher late mortality. Compared with expected survival,
patients with the lowest preoperative hemoglobin levels had a worse outcome, whereas patients with the highest
hemoglobin levels had a better outcome.
Conclusions —A lower preoperative hemoglobin level is an independent predictor of late mortality in patients undergoing
CABG, whereas anemia is a risk factor for early and late mortality. Compared with the general population, anemic
patients had worse surv
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