Treating Anemia in the Preanesthesia Assessment Clinic: Results of a Retrospective Evaluation

Abstract

An anemia clinic within the preanesthesia assessment clinic is a feasible and effective approach to treat preoperative anemia. The IVI supplementation was safe but was associated with decreased RBC transfusions in gynecology/obstetric patients only. The conclusions from this retrospective analysis have to be tested in prospective, controlled trials.

Hepcidin as a potential predictor for preoperative anemia treatment with intravenous iron—A retrospective pilot study

“…Anemic patients who had received IV iron (n = 40) in the PBM/anesthesia clinic, had higher delta Hgb levels (0.45g/dl [0.05, 1.05]) compared to untreated anemic patients (n = 26) (0.1g/dl [-0.48, 0.73]; *p = 0.03) ( Fig 2B ). The data indicate that preoperative IV iron administration increased Hgb levels in the preoperative setting in the current cohort of patients planned for elective surgery, comparable to the data published for the whole patient cohort [ 12 ].…”

“…In this retrospective pilot study, no formal sample size calculation was performed. The participants of this study are a subgroup of the patients seen in the anesthesia/PBM clinic and were all scheduled for elective surgery [ 12 ]. Each patient underwent elective surgery for an intervention that had an increased risk of 10% or more to receive a red blood cell (RBC) transfusion in the year 2013 and were therefore seen in the anesthesia/PBM clinic between 10/2014 and 06/2016 up to one month prior to surgery [ 12 ].…”

“…The participants of this study are a subgroup of the patients seen in the anesthesia/PBM clinic and were all scheduled for elective surgery [ 12 ]. Each patient underwent elective surgery for an intervention that had an increased risk of 10% or more to receive a red blood cell (RBC) transfusion in the year 2013 and were therefore seen in the anesthesia/PBM clinic between 10/2014 and 06/2016 up to one month prior to surgery [ 12 ]. 191 patients, 108 men and 83 women at the age of 22 to 87 years, were included in the study: 48 patients were non-anemic controls, 64 patients were anemic patients without IV iron treatment and 79 patients were anemic patients treated with IV iron.…”

“…As published previously, anemic patients were checked for contraindications prior to an IV iron infusion. Contraindications included severe infections, hepatocellular carcinoma, liver metastases, acute severe asthma, a simultaneous oral iron medication, another IV iron preparation, iron overload, chronic renal failure and regular IV iron substitution, age ≤18 years, pregnancy, lactation and being allergic to iron [ 12 , 17 ]. Patients were excluded due to elevated CRP and leukocyte levels.…”

“…In one of the centers, at Muenster University Hospital, an anesthesia/PBM clinic was established. Anemic patients, who were scheduled for elective surgery were screened for anemia 4 to 28 days prior to surgery and eventually treated with either 500mg or 1000mg of ferric III carboxymaltose (Ferinject ® ) [ 10 – 12 ]. IV iron treatment results in a higher bioavailability of iron and is able to cure iron deficiency and anemia faster than oral iron [ 13 ].…”