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Lasocki, Sigismond; Krauspe, Rüdiger; Heymann, Christian von; Mezzacasa, Anna; Chainey, Suki; Spahn, Donat R.

doi:10.1097/eja.0000000000000202

Cited by 164 publications

(42 citation statements)

References 45 publications

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“…According to a prospective study on patients undergoing hip surgery [35], iron deficiency without anaemia leads to a more frequent preoperative transfusion of blood cells [36], a lowered intravenous iron supplementation transfusion rate, 30-day mortality rate and shortened duration of hospitalisation. Additionally, the majority of surgical patients who had iron deficiency without anaemia became anaemic after surgery [4]. This poses the question whether a potentially easy treatable iron deficiency is co-responsible for postoperative anaemia among the study cohort.…”

Section: Discussionmentioning

confidence: 98%

“…The postoperative complications associated with preoperative anaemia range from stroke, infection [2], pneumonia, sepsis, venous thromboembolism, wound healing disturbance and acute myocardial infarction to cardiac arrest [3]. In regards to postoperative anaemia, a multicentre observational study stated a prevalence of 85.8% among 1534 patients undergoing major elective orthopaedic surgery, highlighting a high-risk group [4]. Further complications, including acute kidney injury (AKI), have been demonstrated for postoperative anaemic patients, presumably caused by a lack of oxygen supply due to reduced oxygen carrying capacity [5].…”

Section: Introductionmentioning

confidence: 99%

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Postoperative anaemia might be a risk factor for postoperative delirium and prolonged hospital stay: A secondary analysis of a prospective cohort study

et al. 2020

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Background Postoperative anaemia is a frequent surgical complication and in contrast to preoperative anaemia has not been validated in relation to mortality, morbidity and its associated health economic effect. Postoperative anaemia can predispose postoperative delirium through impairment of cerebral oxygenation. The aim of this secondary analysis is to investigate the association of postoperative anaemia in accordance with the sex specific World Health Organization definition of anaemia to postoperative delirium and its impact on the duration of hospital stay. Methods A secondary analysis of the prospective multicentric observational CESARO-study was conducted. 800 adult patients undergoing elective surgery were enrolled from various operative disciplines across seven hospitals ranging from university hospitals, district general hospitals to specialist clinics of minimally invasive surgery in Germany. Patients were classified as anaemic according to the World Health Organization parameters, setting the haemoglobin level cut off below 12g/dl for females and below 13g/dl for males. Focus of the investigation were patients with acute anaemia. Patients with present preoperative anaemia or missing haemoglobin measurement were excluded from the sample set. Delirium screening was established postoperatively for at least 24 hours and up to three days, applying the validated Nursing Delirium Screening Scale.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Postoperative anaemia might be a risk factor for postoperative delirium and prolonged hospital stay: A secondary analysis of a prospective cohort study

et al. 2020

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“…Other centers and hospitals around the world face similar problems as there is great need for PBM and difficulties in the implementation [30]. Quality assessment of the new standard of care is one way to successfully enhance the acceptance of PBM [31,32,33].…”

Section: Patient Blood Managementmentioning

confidence: 99%

Patient Blood Management Implementation Strategies and Their Effect on Physicians' Risk Perception, Clinical Knowledge and Perioperative Practice - the Frankfurt Experience

Fischer

Zacharowski

Müller

et al. 2015

Transfus Med Hemother

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Introduction: A multicomponent, evidence-based and interdisciplinary Patient Blood Management (PBM) program was introduced at the University Hospital Frankfurt in July 2013. The implementation strategy included practical and tactical components aimed to increase knowledge on the risks of preoperative anemia, to standardize hemotherapy, and to facilitate PBM components. Methods: This article analyzes barriers to PBM implementation and outlines a strategy to introduce and manifest PBM. The effects in Frankfurt were measured in a before and after questionnaire study distributed among groups of physicians immediately before and 1 year after PBM implementation. Results: 142 clinicians completed the questionnaire in July 2013 and 101 clinicians in August 2014. Absolute certainty that the treatment of preoperative anemia favorably influences morbidity and mortality rose from 25 to 37%. Transfusion behavior seems to have been affected: In 2014, 56% of clinicians stated that they clinically reassess the patient and analyze hemoglobin following each single red blood cell unit compared to only 38% stating this in 2013. Conclusion: These results show that our implementation strategy was effective in changing physicians' risk perception, attitude, and knowledge on PBM principles. Our experience highlights key success factors for the implementation of a comprehensive PBM program.

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“…A preoperative hemoglobin level has been identified as the strongest predictor of the need for transfusion and is related with an increase in mortality. According to a study undertaken by Lasocki et al57), on 1,534 patients who underwent orthopedic surgery, of all 217 patients with a preoperative anemic state, 97.7% maintained an anemic state postoperatively, whereas all 1,317 patients with a non-anemic state preoperatively, 83.8% were switched to an anemic state postoperatively. Furthermore, in a study on 7,759 patients who received non-cardiac surgery, Beattie et al58) reported that preoperative anemia increased the risk of allogeneic transfusion and 90-day mortality.…”

Section: Role Of IV Ironmentioning

confidence: 99%

Management of Blood Loss in Hip Arthroplasty: Korean Hip Society Current Consensus

et al. 2017

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The volume of hip arthroplasty is stiffly increasing because of excellent clinical outcomes, however it has not been shown to decrease the incidence of transfusions due to bleeding related to this surgery. This is an important consideration since there are concerns about the side effects and social costs of transfusions. First, anemia should be assessed at least 30 days before elective hip arthroplasty, and if the subject is diagnosed as having anemia, an additional examination of the cause of the anemia should be carried and steps taken to address the anemia. Available iron treatments for anemia take 7 to 10 days to facilitate erythropoiesis, and preoperative iron supplementation, either oral or intravenous, is recommended. When using oral supplements for iron storage, administer elemental iron 100 mg daily for 2 to 6 weeks before surgery, and calculate the dose using intravenous supplement. Tranexamic acid (TXA) is a synthetic derivative of the lysine component, which reduces blood loss by inhibiting fibrinolysis and clot degradation. TXA is known to be an effective agent for reducing postoperative bleeding and reducing the need for transfusions in primary and revision total hip arthroplasties. Patient blood management has improved the clinical outcome after hip arthroplasty through the introduction and research of various agents, thereby reducing the need for allogeneic blood transfusions and reducing the risk of transfusion-related infections and the duration of hospitalizations.

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Cited by 164 publications

References 45 publications

Postoperative anaemia might be a risk factor for postoperative delirium and prolonged hospital stay: A secondary analysis of a prospective cohort study

Postoperative anaemia might be a risk factor for postoperative delirium and prolonged hospital stay: A secondary analysis of a prospective cohort study

Patient Blood Management Implementation Strategies and Their Effect on Physicians' Risk Perception, Clinical Knowledge and Perioperative Practice - the Frankfurt Experience

Management of Blood Loss in Hip Arthroplasty: Korean Hip Society Current Consensus

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