Increased preoperative serum vitamin B12 level as a predictor of postoperative mortality in patients undergoing cardiac surgery

Lee, Seohee; Nam, Karam; Jung, Sun‐Young; Park, Dongnyeok; Ju, Jae-Woo; Bae, Je Hyun; Cho, Youn Joung; Jeon, Yunseok

doi:10.23736/s0375-9393.22.16297-8

Cited by 4 publications

(2 citation statements)

References 24 publications

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“…In addition to focusing on iron deficiency, vitamin B12 and folate deficiencies should also be identified and treated preoperatively; low B12 levels even correlate with mortality after cardiac surgery. 30 Aggressive supplementation of both B12 and folic acid may be pursued as repletion of each presents very little risk. 31 A randomized, placebo-controlled study was conducted to address extreme short-term treatment with a combination of subcutaneous erythropoietin 40 000 units, subcutaneous vitamin B12, oral folate 5 mg, and 20 mg/ kg of ferric carboxymaltose in patients with anemia and iron deficiency 1 day before cardiac surgery.…”

Section: Preoperative Anemiamentioning

confidence: 99%

Prehabilitation of Cardiac Surgical Patients, Part 1: Anemia, Diabetes Mellitus, Obesity, Sleep Apnea, and Cardiac Rehabilitation

Knight

Subramanian

Sultan

et al. 2022

Semin Cardiothorac Vasc Anesth

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The concept of “prehabilitation” consists of screening for and identification of pre-existing disorders followed by medical optimization. This is performed for many types of surgery, but may have profound impacts on outcomes particularly in cardiac surgery given the multiple comorbidities typically carried by these patients. Components of prehabilitation include direct medical intervention by preoperative specialists as well as significant care coordination and shared decision making. In this two-part review, the authors describe existing evidence to support the optimization of various preoperative problems and present a few institutional protocols utilized by our center for cardiac presurgical care. This first installment will focus on the management of anemia, obesity, sleep apnea, diabetes, and cardiac rehabilitation prior to surgery. The second will focus on frailty, malnutrition, respiratory disease, alcohol and smoking cessation, and depression.

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Section: Preoperative Anemiamentioning

confidence: 99%

Prehabilitation of Cardiac Surgical Patients, Part 1: Anemia, Diabetes Mellitus, Obesity, Sleep Apnea, and Cardiac Rehabilitation

Knight

Subramanian

Sultan

et al. 2022

Semin Cardiothorac Vasc Anesth

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“…[9][10][11][12] There are four major pathophysiological mechanisms that explain the presence of elevated B12 levels in blood: 1) a direct increase in plasma B12 by excess intake or administration, 2) a direct increase in plasma B12 by liberation from an internal reservoir, 3) an increase in transcobalamin (TCB) via excess production or lack of clearance, and 4) a quantitative deficiency or lack of affinity of TCB for B12. 6 On the other hand, although several studies in inpatients have described a positive correlation between elevated B12 levels and mortality, [13][14][15][16][17][18] there is currently no consensus on the cut-off point, so it is generally defined as the upper limit of the normal range at each laboratory. 14,19 In addition, it should be noted that in some patients in these studies, the diagnosis or cause of death had not been clearly established at the time of measurement of B12 levels, nor is there a widely accepted diagnostic algorithm for the study of patients with high B12 levels in the hospital setting.…”

Section: Introductionmentioning

confidence: 99%

Hipervitaminemia B12 y mortalidad en pacientes hospitalizados en un hospital universitario en Colombia

Molina Pimienta,

Amado-Garzón,

Salgado Sanchez

et al. 2023

Rev. Fac. Med.

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Introducción: Se ha reportado una asociación entre los niveles altos de vitamina B12 y la ocurrencia de múltiples enfermedades. Objetivo: describir las características clínicas de pacientes hospitalizados con hipervitaminemia B12, así como la tasa de mortalidad a un año. Materiales y métodos: estudio observacional retrospectivo realizado en 93 pacientes con hipervitaminemia B12 atendidos en el Hospital Universitario San Ignacio, en Bogotá Colombia entre 2013 y 2020. Los datos se describen utilizando medidas de tendencia central y de dispersión. Se realizaron análisis bivariados (prueba t de dos colas no pareada, prueba de chi-cuadrado o prueba U de Mann-Whitney según el tipo de variable) para determinar diferencias entre los pacientes con niveles altos de B12 y aquellos con niveles muy altos. Resultados: La mediana de edad fue 68 años y el 62.36% de los pacientes eran hombres. El 41.93% de los participantes tenía dos o más comorbilidades asociadas con la hipervitaminemia B12. Además, en 86.02% el nivel de vitamina B12 no fue interpretado como anormal por el médico tratante. Se encontraron diferencias significativas en el antecedente de tabaquismo (p = 0.043) y la presencia de lupus eritematoso sistémico (p = 0.012) entre los pacientes con niveles de B12 altos y aquellos con niveles muy altos. Finalmente, la tasa de mortalidad a 1 año fue de 59.13%. Conclusión: la tasa de mortalidad a un año fue alta y un elevado porcentaje de pacientes tenía al menos dos comorbilidades asociadas a la hipervitaminemia B12. Además, en la mayoría de los participantes, el médico tratante no interpretó correctamente el nivel elevado de esta vitamina.

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A year in review in Minerva Anestesiologica 2022: anesthesia, analgesia, and perioperative medicine

et al. 2023

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Increased preoperative serum vitamin B12 level as a predictor of postoperative mortality in patients undergoing cardiac surgery

Cited by 4 publications

References 24 publications

Prehabilitation of Cardiac Surgical Patients, Part 1: Anemia, Diabetes Mellitus, Obesity, Sleep Apnea, and Cardiac Rehabilitation

Prehabilitation of Cardiac Surgical Patients, Part 1: Anemia, Diabetes Mellitus, Obesity, Sleep Apnea, and Cardiac Rehabilitation

Hipervitaminemia B12 y mortalidad en pacientes hospitalizados en un hospital universitario en Colombia

A year in review in Minerva Anestesiologica 2022: anesthesia, analgesia, and perioperative medicine

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