Letter to the Editor
Reply
Respuesta
Esteban Gracia Carlos
Servicio de Angiología y Cirugía Vascular Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
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We consider that the main contribution of our study is that preoperative anaemia in patients who underwent elective aortic-peripheral vascular surgery is a poor short and medium-term prognosis factor. In addition, this factor can be corrected with adequate study and subsequent treatment.</p><p id="par0010" class="elsevierStylePara elsevierViewall">It must be taken into account that, in 80% of the cases, the patient cohort studied does not go through the normal pre-anaesthetic consultation, 3 and 4 weeks before surgery, because surgery will not be delayed much more than one or 2 weeks when dealing with patients with critical ischemia. This means that they require specific action protocols beyond those included in the general surgical setting.</p><p id="par0015" class="elsevierStylePara elsevierViewall">We are aware of the limitations of the study, especially because it is retrospective and observational. The negative association between anaemia and short and medium-term progression for vascular patients is currently well documented in the literature.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Perhaps the aspect that remains to be demonstrated would be the positive association between the correct management of anaemia in the peri and postoperative period and the subsequent patient outcome. To date, no work has been published that studies this association as a primary endpoint in a prospective or randomized manner.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Our workgroup is currently considering that line of research for the future. In fact, this research has been initiated in England in a significant way, with the design of a prospective study (CAVIAR study). The aim of the study is to compare 2-groups of patients according to whether they receive preoperative treatment for their anaemia or not. In addition, secondary objectives include changes in iron deficiency biomarkers, average hospital stay and postoperative quality of life.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Esteban Gracia C. Respuesta a «Anemia en pacientes sometidos a cirugía vascular, factor predictor de amputación y muerte». Med Clin (Barc). 2019;153:473.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anaemia in patients who underwent vascular surgery: a significant predictor of amputation and death" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C Esteban" 1 => "P Rodríguez" 2 => "JR Escudero" 3 => "A Clarà" 4 => "A Fernández" 5 => "S Fernández" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medcli.2018.01.029" "Revista" => array:6 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "2019" "volumen" => "152" "numero" => "Jan 4(1)" "paginaInicial" => "6" "paginaFinal" => "12" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The UK Cardiac and Vascular Surgery Interventional Anaemia Response (CAVIAR) Study: protocol for an observational cohort study to determine the impact and effect of preoperative anaemia management in cardiac and vascular surgical patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Chau" 1 => "T. Richards" 2 => "C. Evans" 3 => "A. Butcher" 4 => "T. Collier" 5 => "A. Klein" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bmjopen-2016-014872" "Revista" => array:5 [ "tituloSerie" => "BMJ Open" "fecha" => "2017" "volumen" => "7" "numero" => "Apr 18(4)" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28928183" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015300000012/v1_201912120702/S2387020619304784/v1_201912120702/en/main.assets" "Apartado" => array:4 [ "identificador" => "43309" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015300000012/v1_201912120702/S2387020619304784/v1_201912120702/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020619304784?idApp=UINPBA00004N" ]
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