AB209. 239. An audit of pre-operative anaemia and associated blood transfusion in patients attending the pre-operative assessment clinic at University Hospital Limerick

Background: Perioperative anaemia is an independent risk factor for poor surgical outcome. Furthermore, blood transfusions carry their own risk. Anaemia should be investigated and treated before planned surgery, using haematinics as intravenous iron rather than transfusion”. To investigate adherence to the WHO guidelines for anaemia in the preoperative patients. Are anaemic patients identified and appropriate interventions applied?

Methods: We performed a retrospective review of 653 patients attending our preoperative assessment clinic. Haemoglobin levels, treatment provided and transfusion records were collated. Patients were classified as being anaemic if their haemglobin levels were <12 g/dL for women and <13 g/dL for men. Anaemia was deemed mild if Hb >10 g/dL, moderate to severe if Hb <10 g/dl.

Results: Of 653 patients, 159 were anaemic, 80% were mild (73 female, 54 male) and 20% severe (19 females, 13 males). Iron studies were performed in just 31%. Intravenous iron was administered in just 9 cases (3 mild and 6 severe). Twenty-four patients were transfused peri-operatively (12 mild, 12 severely anaemic). Only five received intravenous iron preoperatively.

Conclusions: This audit highlights the need for improved education and vigilance in relation to peri-operative anaemia and outlines an area for significant improvement in patient care. Intravenous iron is safe, effective currently under-utilised in anaemic patients.

Keywords: Pre-operative anaemia; intravenous iron