This multi-centre project used data from all 4 hospitals in the Severn region enrolled in the Perioperative Quality Improvement Programme (PQIP). We aimed to establish the proportion of patients presenting for elective surgery with anaemia, determine any difference in outcomes such as transfusion rates, complications and length of stay. Local guidelines for preoperative anaemia management, along with measures employed locally to reduce intraoperative blood loss were also reviewed to identify variations in practice.
We found that over 30% of patients presenting for elective surgery across the South West are anaemic, and there are important differences in the assessment and management between centres. We know from the literature that complication rates in anaemic patients are higher and we found a similar trend here. We identified challenges of optimising haemoglobin in particular cohorts of patients (patients undergoing cancer operations who cannot be delayed), and how some sites have introduced pathways that enable patients to have rapid access to intravenous iron pre-surgery. There was a suggestion that centres screening with Point of Care testing can facilitate earlier treatment of iron deficiency anaemia, and reduce its incidence.
The project was presented as a poster at the RCoA Anaesthesia Conference in May 2019 and acknowledged in the PQIP annual report for sharing ideas to support quality improvement across the region.