Evaluation of anemia in the elective surgical patient

SUMMARY A national audit demonstrated that 35% of patients scheduled for orthopedic joint replacement surgery have a hemoglobin concentration < 13 g/dL on preadmission testing. Current practice consists of preadmission testing within 72 hours before an elective operative procedure, which precludes the opportunity effectively to evaluate and manage a patient with unexpected anemia. A standardized approach for the detection, evaluation and management of anemia in the preoperative surgical setting was identified as an unmet medical need. A panel of physicians developed a clinical care pathway for anemia management in this setting. Recommendations were that patients undergoing elective surgery should receive a hemoglobin determination up to 30 days before the scheduled surgical procedure. The identification and evaluation of anemia in this setting will assist in expedited diagnosis and treatment of underlying comorbidities, and will improve patient outcomes.