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Title: Prevalence and causes of preoperative anaemia in elective major surgery patients
Austin Authors: Hong, Frank S;Sieradzki, Nicole;Pollock, Claire;Nasra, Faye;Mo, Allison ;Willcox, Abbey ;Churilov, Leonid ;Ho, Wai Khoon ;Smith, Carole
Affiliation: Department of Laboratory Haematology, Austin Health, Heidelberg, Victoria, Australia
Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia
Statistics and Decision Analysis Academic Platform, Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
School of Science, RMIT University, Melbourne, Victoria, Australia
Issue Date: 4-Sep-2017
Date: 2017-09-04
Publication information: Internal Medicine Journal 2017; 47(12): 1400-1404
Abstract: BACKGROUND: Preoperative anaemia is associated with increased morbidity and mortality in surgical patients. Recent national patient blood management guideline recommended screening surgical patients for anaemia and in particular iron deficiency anaemia, without reference to the prevalence of anaemia or iron deficiency anaemia in this patient population. AIMS: To establish the prevalence and cause of preoperative anaemia in elective major surgery patients. METHODS: Patients attending the anaesthetic pre-admission clinics from 1 July 2013 to 30 June 2014 prior to their major elective surgery in our institution were screened for anaemia and iron deficiency by measuring full blood count, iron studies and C-reactive protein. Patients who were anaemic were either further assessed in haematology clinic or had their medical records reviewed to ascertain the cause of the anaemia. RESULTS: Two hundred and eight (13.9%) of 1494 patients were anaemic, with a male predominance (70.7%). Fifty seven (27.4%) of them had iron deficiency anaemia. Other common causes of anaemia include underlying malignancy (18.3%), end stage renal failure (11.5%) and other chronic diseases (7.2%). In 53 patients (25.5%), the cause was unknown. Anaemia was most commonly found in patients scheduled for gastrointestinal surgery. CONCLUSION: Preoperative anaemia affects 13.9% of patients undergoing elective major surgery. The most common causes are iron deficiency and chronic diseases. The cause was unexplained in 25.5% of patients with anaemia. The prevalence of anaemia in different surgical specialties may have implications on the approach to screening, particularly in resource limited areas.
DOI: 10.1111/imj.13613
ORCID: 0000-0003-2216-6004
Journal: Internal Medicine Journal
PubMed URL:
Type: Journal Article
Subjects: Surgical procedures
Iron deficiency anaemia
Appears in Collections:Journal articles

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