Management of preoperative anaemia in patients undergoing elective surgery

Previously undiagnosed anaemia is commonly identified during preadmission testing in patients undergoing elective surgery. Anaemia in these patients and related perioperative therapy have been associated with increased morbidity (including increased rates of perioperative infection) and mortality. Clinical care pathways for patients in these settings have been developed by the Society for Blood Management (SABM) and the Network for the Advancement of Transfusion Alternatives (NATA). These consensus recommendations emphasize the following: (1) preadmission testing, including complete blood counts (CBC) that should occur as close as possible to 30 days before the scheduled surgery date; (2) any anaemia identified should be evaluated and managed before surgery; (3) evaluations and laboratory testing should be performed to rule out nutritional causes (particularly iron deficiency), chronic kidney disease and/or anaemia of inflammation and (4) management of anaemia should include consideration of IV iron therapy and/or therapy with erythropoiesis-stimulating agents (ESA).