Feasibility and efficiency of a preoperative anaemia walk-in clinic: secondary data from a prospective observational trial

<span class="paragraphSection">Editor—Preoperative anaemia is independently associated with increased risk of morbidity and mortality.<a href="#aex024-B1" class="reflinks">¹</a> Although haemoglobin (Hb) levels are always measured before major surgery, preoperative anaemia management is not implemented in most hospitals worldwide. Here we report the first steps and pilot clinical effects of implementing a preoperative anaemia clinic to diagnose and treat iron deficiency anaemia (IDA), which continues to be the top ranking cause worldwide,<a href="#aex024-B2" class="reflinks">²</a> to optimise preoperative anaemia and to reduce unnecessary red blood cell (RBC) utilization. This study is embedded in a previously published observational trial demonstrating the beneficial effects of implementing a patient blood management program.<a href="#aex024-B3" class="reflinks">³</a> A defined preoperative patient pathway including screening process, diagnostic algorithms and treatment protocol was developed.<a href="#aex024-B4" class="reflinks">⁴</a> The study protocol was approved by the ethics committee at the University Hospital Frankfurt. Primary endpoints were Hb increase and RBC transfusion rate. For the analysis of the dynamics of Hb levels over time, a complex non-parametric mixed effects model was used considering patients as random effects.<a href="#aex024-B5" class="reflinks">⁵</a> Data are provided as mean (<span style="text-transform:lowercase;font-variant:small-caps;">sem</span>) and median [interquartile range (IQR)]. <span style="font-style:italic;">P</span>-values <0.005 were considered statistically significant.</span>

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