1. Prevalence and intervention of preoperative anemia in Chinese adults: A retrospective cross-sectional study based on national preoperative anemia database
- Author
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Futing Sun, Zhonghua Jia, Xiaoyan Li, Shuhuai Zhong, Chunya Ma, Shanshan Liu, Yang Yu, Xiaojun Guo, Shuxuan Ma, Chao Wang, Shu-fang Wang, Junting Liu, Yi Lv, Xiaozhen Guan, Jie Lin, Zunyan Li, Shengxiong Chen, Fenghua Liu, Hailan Li, Hai-bao Wang, Cheng Shijun, Na Li, Aiqing Wen, Jun Zhang, Lingling Zhou, Long Zhang, Gang Li, Jun Yang, Deqing Wang, Zhenhua Xu, and Jufeng Wu
- Subjects
Medicine (General) ,Blood management ,Cross-sectional study ,Iron ,computer.software_genre ,01 natural sciences ,03 medical and health sciences ,R5-920 ,0302 clinical medicine ,hemic and lymphatic diseases ,Medicine ,Preoperative anemia ,030212 general & internal medicine ,Vitamin B12 ,0101 mathematics ,Erythropoietin ,Database ,business.industry ,Transfusion ,010102 general mathematics ,Chinese adults ,General Medicine ,Perioperative ,Folic acid ,business ,computer ,medicine.drug ,Research Paper - Abstract
Background Preoperative anemia is an important pillar of perioperative patient blood management. However, there was no literature comprehensively described the current situation of preoperative anemia in China. Methods We conducted a national retrospective cross-sectional study to assess the prevalence and intervention of preoperative anemia in Chinese adults. Data were from the National Preoperative Anemia Database based on hospital administration data from January 1, 2013 to December 31, 2018. Findings A total of 797,002 patients were included for analysis. Overall, 27.57% (95% CI 27.47–27.67) of patients had preoperative anemia, which varied by gender, age, regions, and type of operation. Patients who were female, age over 60 years old, from South China, from provinces with lower per capita GDP, underwent operations on the lymphatic and hematopoietic system, with laboratory abnormalities were more likely to have a high risk of preoperative anemia. Among patients with preoperative anemia, 5.16% (95% CI 5.07–5.26) received red blood cell transfusion, 7.79% (95% CI 7.67–7.91) received anemia-related medications such as iron, erythropoietin, folic acid or vitamin B12, and 12.25% (95% CI 12.10–12.40) received anemia-related therapy (red blood cell transfusion or anemia-related medications) before operation. The probability of preoperative RBC transfusion decreased by 54.92% (OR 0.46, 95% CI 0.46–0.47) as each 10-g/L increase in preoperative hemoglobin. Patients with preoperative hemoglobin less than 130 g/L was associated with longer hospital stay and more hospital costs. Patients with severe preoperative anemia given iron preoperatively had lower intra/post-operative RBC transfusion rate, shorter length of stay and less hospitalization costs, but no similar correlation was found in patients with mild and moderate preoperative anemia and patients given erythropoietin preoperatively. Interpretation Our present study shows that preoperative anemia is currently a relatively prevalent problem that has not been fully appreciated in China. More researches will be required to optimize the treatment of preoperative anemia. Funding National Natural Science Foundation of China and the Logistics Support Department of the Central Military Commission.
- Published
- 2020