Hong Frank S, Sieradzki Nicole, Pollock Claire, Nasra Faye, Mo Allison, Willcox Abbey, Churilov Leonid, Ho Wai Khoon, Smith Carole
Department of Laboratory Haematology, Austin Health, Melbourne, Victoria, Australia.
Department of Anaesthesia, Austin Health, Melbourne, Victoria, Australia.
Intern Med J. 2017 Dec;47(12):1400-1404. doi: 10.1111/imj.13613.
Preoperative anaemia is associated with increased morbidity and mortality in surgical patients. Recent national patient blood management guideline recommended screening surgical patients for anaemia, particularly iron deficiency anaemia, without reference to the prevalence of anaemia or iron deficiency anaemia in this patient population.
To establish the prevalence and cause of preoperative anaemia in elective major surgery patients.
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 the haematology clinic or had their medical records reviewed to ascertain the cause of the anaemia.
Of 1494 patients, 208 (13.9%) were anaemic, with a male predominance (70.7%); 57 (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.
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.
术前贫血与外科手术患者发病率和死亡率增加相关。近期的国家患者血液管理指南建议对外科手术患者进行贫血筛查，尤其是缺铁性贫血，而未提及该患者群体中贫血或缺铁性贫血的患病率。
确定择期大手术患者术前贫血的患病率及病因。
对2013年7月1日至2014年6月30日在我院接受择期大手术前到麻醉科入院前门诊就诊的患者，通过检测全血细胞计数、铁代谢指标和C反应蛋白来筛查贫血和缺铁情况。贫血患者要么在血液科进一步评估，要么查阅其病历以确定贫血原因。
1494例患者中，208例（13.9%）贫血，男性居多（70.7%）；其中57例（27.4%）为缺铁性贫血。贫血的其他常见病因包括潜在恶性肿瘤（18.3%）、终末期肾衰竭（11.5%）和其他慢性疾病（7.2%）。53例患者（25.5%）病因不明。贫血在计划进行胃肠道手术的患者中最为常见。
术前贫血影响13.9%的择期大手术患者。最常见的病因是缺铁和慢性疾病。25.5%的贫血患者病因不明。不同外科专科的贫血患病率可能对筛查方法有影响，尤其是在资源有限的地区。
