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Published VersionCC BY-NC V4.0, Open Access
Journal article
Preoperative Anemia Screening and Treatment Practices in Patients Having Total Joint Replacement Surgery: A Retrospective, Observational Audit
Journal of Blood Medicine, Vol.11, pp.259-265
2020
PMCID: PMC7418168
PMID: 32821186
Abstract
Background: Surgical patients with preoperative anemia are more likely to experience adverse outcomes. Patient blood management (PBM) guidelines recommend screening and treating patients for anemia preoperatively to enable optimisation before surgery. This study investigates compliance with PBM guidelines and reports the association between length of stay and transfusion risk in patients with preoperative anemia.
Study Design and Methods: A retrospective, observational, chart audit that included all patients having primary, total hip and knee replacement surgery between July- December 2018 at a tertiary, metropolitan healthcare facility.
Results: Six hundred and seven patients patients were included, 96% (n = 583) patients had blood tests available (full blood count), and 8.1% (n = 49) had iron studies. Most patients 53% (n = 324) were screened between 2 and 6 days before surgery; 14.6% (n = 85) were anaemic preoperatively and only 5.9% (n = 5) of anaemic patients received treatment. Patients who had anemia preoperatively were more likely to receive a blood transfusion (odds ratio 8.65 [95% CI 3.98-18.76]) and stayed longer in hospital (median difference = 1, chi(2)(LR) = 17.2, df=1, p<0.007).
Conclusion: Tests ordered for patients having major surgery should include iron studies, renal function, CRP and full blood count to enable detection and classification of preoperative anemia. Timing of screening relative to surgery needs to be sufficient to allow patient optimisation to occur. Appropriate treatment should be provided to anaemic patients to prevent unnecessary blood transfusions and reduce the length of stay. A standardised pre-operative anemia pathway may assist in improving practice.
Details
- Title
- Preoperative Anemia Screening and Treatment Practices in Patients Having Total Joint Replacement Surgery: A Retrospective, Observational Audit
- Authors
- Alana Delaforce (Corresponding Author) - University of Newcastle AustraliaLemya Galeel (Author) - Mater Health ServicesEdgar Poon (Author) - The University of QueenslandCameron Hurst (Author) - QIMR Berghofer Medical Research InstituteJed Duff (Author) - Queensland University of TechnologyJudy Munday (Author) - Queensland University of TechnologyJanet Hardy (Author) - Mater Health Services
- Publication details
- Journal of Blood Medicine, Vol.11, pp.259-265
- Publisher
- Dove Medical Press Ltd
- Date published
- 2020
- DOI
- 10.2147/JBM.S254116
- ISSN
- 1179-2736
- PMID
- 32821186; PMC7418168
- Copyright note
- © 2020 The Author(s). This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.
- Organisation Unit
- School of Health - Nursing
- Language
- English
- Record Identifier
- 99991177402621
- Output Type
- Journal article
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- Hematology
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