BackgroundAbout Pre-Operative Anaemia or Iron Deficiency
This pathway demonstrates the approach to anaemia or iron deficiency if detected at preassessment. The preassessment team will give the patient a letter to present to their GP indicating that anaemia or iron deficiency is present and requires further action. The patient will be contacted by preassessment six months later, and if no further action has been taken it is possible that their elective operation will be cancelled.
Definition of Anaemia:
- Hb <130g/L in males
- Hb <120g/L in females
Definition of Iron deficiency:
- Ferritin <30ug/L and CRP normal; or
- Ferritin <100ug/L with elevated CRP.
These definitions are based on international guidelines of iron deficiency. Ferritin is elevated in inflammation, infection, liver disease and malignancy. This can result in misleadingly elevated ferritin levels in iron-deficient patients with coexisting systemic illness.
Optimising iron stores prior to elective surgery where projected blood loss is high (eg joint replacement) leads to substantially lower patient morbidity and mortality.