{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T17:45:36Z","timestamp":1776015936090,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background\/Aim<\/jats:title>\n                    <jats:p>There has been a drive on improving outcomes after Emergency Laparotomy (EmLap) due to the National Emergency Laparotomy Audit (NELA). This has focused mainly on preoperative and intraoperative management with less emphasis on other perioperative aspects. We aimed to assess the prevalence of anemia in EmLap patients and its management in a perioperative period, exploring the gaps in anemia care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study of prospectively maintained database of 1055 EmLap patients (2016\u20132019) from a UK tertiary center was performed. Data were extracted from the NELA database, POLO study, electronic records (Welsh Clinical Portal). Statistics were performed in SPSS v27.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 740 patients, 77% underwent open surgery, with mean age of 61.9\u00a0years (range 18\u201398), median age of 65\u00a0years, and roughly equal sex distribution (female 54%). The median preoperative NELA risk was 3.6% (IQR 1.1\u20139.8). Over a quarter of patients (28.6%) were anemic on admission. Anemic patients had significantly longer hospital stays (median 12\u00a0days; &gt;\/\u00a0=\u00a011\u00a0days,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.008) and higher stoma formation rates (54.1% moderate anemia vs. 34.3% nonanemic;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.002). Three\u2010quarters of patients (74.2%) were anemic at discharge (median Hb: 108\u00a0g\/L, range: 74\u2013129\u00a0g\/L) but only 12% were treated with oral or IV iron or blood transfusion; only 10% had anemia reported in their discharge letters with appropriate follow\u2010up and management plan.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Anemia in patients undergoing emergency laparotomy is significantly under\u2010recognized and inadequately managed at discharge, despite recognized increased morbidity. A structured pathway for continuing anemia treatment and discharge planning is urgently needed to improve outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70301","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T04:34:58Z","timestamp":1773722098000},"page":"891-897","source":"Crossref","is-referenced-by-count":0,"title":["Management of PErioperative Anemia in EmeRgency Laparotomy Patients (PEARL Study)"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4347-237X","authenticated-orcid":false,"given":"Vignesh","family":"Lakshmanan","sequence":"first","affiliation":[{"name":"Cardiff and Vale University Health Board (CAVUHB) University Hospital of Wales  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3915-8489","authenticated-orcid":false,"given":"Dhanya Lakxmi","family":"Nantha Kumar","sequence":"additional","affiliation":[{"name":"Cardiff University  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carven","family":"Chin","sequence":"additional","affiliation":[{"name":"Cardiff and Vale University Health Board (CAVUHB) University Hospital of Wales  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander H. M.","family":"Lukaszewicz","sequence":"additional","affiliation":[{"name":"Cardiff and Vale University Health Board (CAVUHB) University Hospital of Wales  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9031-7516","authenticated-orcid":false,"given":"Alun","family":"Meggy","sequence":"additional","affiliation":[{"name":"Cardiff and Vale University Health Board (CAVUHB) University Hospital of Wales  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9858-8011","authenticated-orcid":false,"given":"Louise M.","family":"Silva","sequence":"additional","affiliation":[{"name":"Cardiff and Vale University Health Board (CAVUHB) University Hospital of Wales  Cardiff UK"},{"name":"Cardiff University  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3218-0574","authenticated-orcid":false,"given":"Jared","family":"Torkington","sequence":"additional","affiliation":[{"name":"Cardiff and Vale University Health Board (CAVUHB) University Hospital of Wales  Cardiff UK"},{"name":"Cardiff University  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4360-4472","authenticated-orcid":false,"given":"Julie A.","family":"Cornish","sequence":"additional","affiliation":[{"name":"Cardiff and Vale University Health Board (CAVUHB) University Hospital of Wales  Cardiff UK"},{"name":"Cardiff University  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12871\u2010020\u201001024\u20108"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15847"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/eja.0000000000002070"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0229325"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.2478\/jccm\u20102021\u20100028"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15021"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2020.02.043"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010022\u201018417\u2010z"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.13068"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15859"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.16291"},{"key":"e_1_2_11_13_1","volume-title":"Guideline for the Management of Anaemia in the Perioperative Pathway","author":"Centre for Perioperative Care (CPOC)","year":"2025"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(20)31539\u20107"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2025.103361"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2021.06.029"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010025\u201085898\u2010z"},{"key":"e_1_2_11_18_1","unstructured":"National Institute for Health and Care Excellence Perioperative Care in Adults (NICE Guideline CG180) (2020) https:\/\/www.nice.org.uk\/guidance\/ng180."},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102023\u2010081821"},{"key":"e_1_2_11_20_1","volume-title":"Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment of Severity","author":"World Health Organization","year":"2011"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010147\u20108\u2010200710160\u201000010"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473\u20103099(18)30101\u20104"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znad377"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12262\u2010021\u201002967\u2010z"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012451.pub2"},{"key":"e_1_2_11_26_1","unstructured":"Royal College of Surgeons of England The High\u2010Risk General Surgical Patient: Raising the Standard 3rd ed. (2018) https:\/\/www.rcseng.ac.uk\/\u2010\/media\/files\/rcs\/news\u2010and\u2010events\/media\u2010centre\/2018\u2010press\u2010releases\u2010documents\/rcs\u2010report\u2010the\u2010highrisk\u2010general\u2010surgical\u2010patient\u2010\u2010raising\u2010the\u2010standard\u2010\u2010december\u20102018.pdf."},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.51725"},{"key":"e_1_2_11_28_1","unstructured":"NHS Wales Postoperative Anaemia Pathway Version 1.0. 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