Introduction
Preoperative anaemia is a major risk factor for peri-operative blood transfusion,
which is associated with postoperative morbidity and mortality.World Health Organisation(WHO)
states that every effort should be made to optimise surgical patient's own blood volume
using a patient blood management(PBM) approach as it has been shown to improve outcomes
and reduce healthcare costs in a number of studies. So, this study was aimed to identify
the prevalence of preoperative anaemia, evaluate the preoperative intervention program
and peri-operative transfusion rates among patients undergoing cardio-thoracic surgery
Methods
We collected data retrospectively over a period of one month from patients who underwent
cardiac and thoracic surgery in a university teaching hospital. Anaemia was defined
as haemoglobin concentration below 130g/l for men and 120g/l in female.
Results
A total of 120 (67-Cardiac surgery,53-Thoracic surgery) adult patients undergoing
cardio-thoracic surgery were included in the study. Majority of the patients (55%
of cardiac surgery and 60% of thoracic surgery patients)belonged to 60-80 Age group.
Pre-operative anaemia was present in 31% of cardiac patients and 35% of thoracic patients.
None of the patients in the cardiac group was referred to anaemia clinic or received
any iron supplements or pre-op blood transfusion. One patient in the thoracic group
was referred to anaemia clinic and received IV iron.
In the cardiac group, 57% of anaemic patients received blood transfusion intra-operatively
and 28% postoperatively whereas only 9% of non-anaemic patients received blood transfusion
intra-operatively and 2% post operatively.
In the thoracic group, 10% of anaemic patients received blood transfusion intra-op
and non-post op. In the non anaemic group, none received blood transfusion. Haematinics
were prescribed post operatively for 60% patients in the cardiac group.
Discussion
Preoperative anaemia was present nearly one-third of patients (31% cardiac surgery
and 35% thoracic surgery)at our centre. However, blood transfusion requirements were
significantly high among cardiac surgery patients compared to thoracic surgery patients.
Referral and anaemia treatment were infrequently initiated in preoperative anaemic
patients. Following the audit, significant changes have been made regarding anaemia
referral and optimisation of anaemia preoperatively. Repeat audit is planned in six
months time to review the change in practice.
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© 2021 Published by Elsevier Inc.
