Anaemia is associated with adverse outcomes of surgery. The blood loss of surgery or trauma can cause or worsen anaemia. People who have anaemia have a worse result from their operation including poorer wound healing, slower mobilisation and an increased risk of death.
The Centre for Perioperative Care (CPOC) perioperative anaemia guideline has been developed using a whole pathway approach. It contains recommendations for patients of all ages undergoing surgery and for healthcare professionals in both emergency and elective surgical settings and across specialties. The aim of this guideline is to ensure that the patient is at the centre of the whole process, and that everyone involved in their care carries out their individual responsibilities to minimise the risk from anaemia.
To make the best of this approach we need to make sure patients and all health care professionals including GPs and multidisciplinary hospital teams work together to:
- Identify anaemia early in the pathway.
- Make the patient aware of this and all actions going forward.
- Find the cause of the anaemia.
- Use tried and tested treatments for anaemia before surgery. This could include advice on changes in diet, oral treatments such as iron supplements and the use intravenous iron when necessary.
- Make sure the patient has a personalised treatment programme including providing appropriate information about the pros and cons of the different approaches suggested to the patient and how long these should be continued.
- Communicate clearly between different members of the team so that operations are not cancelled unnecessarily and improve the interface between primary care and hospitals.
- Talk openly to the patient about the benefits and risks of managing anaemia and the surgery.