Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Dec 6;2019(1):570-576.
doi: 10.1182/hematology.2019000061.

Preoperative anemia-screening clinics

Yulia Lin  1
Affiliations
Review

Preoperative anemia-screening clinics

Yulia Lin. Hematology Am Soc Hematol Educ Program. .

Abstract

Preoperative anemia is associated with increased postoperative morbidity and mortality and with increased risk of perioperative transfusion. It is an important and modifiable risk factor for surgical patients. For high-blood-loss surgery, preoperative anemia is defined as hemoglobin <13 g/dL for both male and female patients. Preoperative anemia is common, ranging from 25% to 40% in large observational studies. The most common treatable cause of preoperative anemia is iron-deficiency anemia; the initial laboratory tests should focus on making this diagnosis. Management of iron-deficiency anemia includes iron supplementation with IV iron therapy when oral iron is ineffective or not tolerated, there is severe anemia, and there is insufficient time to surgery (<4 weeks). In other situations, erythropoiesis-stimulating agents may be considered, particularly for those patients with multiple alloantibodies or religious objections to transfusion. To facilitate the diagnosis and management of preoperative anemia, establishment of preoperative anemia-screening clinics is essential. The goals of management of preoperative anemia are to treat anemia, reduce the need for transfusion, and improve patient outcomes.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest disclosure: Y.L. has received research funding from Novartis and Octapharma and consulting fees from Amgen and Pfizer.

Figures

Figure 1.
Figure 1.
Preoperative anemia management algorithm. CRP, C reactive protein; ESA, erythropoiesis stimulating agent; TSAT, transferrin saturation.
See this image and copyright information in PMC

References

    1. Fowler AJ, Ahmad T, Phull MK, Allard S, Gillies MA, Pearse RM. Meta-analysis of the association between preoperative anaemia and mortality after surgery. Br J Surg. 2015;102(11):1314-1324. - PubMed
    1. Mueller MM, Van Remoortel H, Meybohm P, et al. ; ICC PBM Frankfurt 2018 Group. Patient blood management: recommendations from the 2018 Frankfurt Consensus Conference. JAMA. 2019;321(10):983-997. - PubMed
    1. Musallam KM, Tamim HM, Richards T, et al. . Preoperative anaemia and postoperative outcomes in non-cardiac surgery: a retrospective cohort study. Lancet. 2011;378(9800):1396-1407. - PubMed
    1. Baron DM, Hochrieser H, Posch M, et al. ; European Society of Anaesthesiology. Preoperative anaemia is associated with poor clinical outcome in non-cardiac surgery patients. Br J Anaesth. 2014;113(3):416-423. - PubMed
    1. Freedman J. The ONTraC Ontario program in blood conservation. Transfus Apheresis Sci. 2014;50(1):32-36. - PubMed