{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T05:58:37Z","timestamp":1772690317328,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,11,5]],"date-time":"2020-11-05T00:00:00Z","timestamp":1604534400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Pre\u2010operative anaemia is associated with higher rates of transfusion and worse outcomes, including prolonged hospital stay, morbidity and mortality. Iron deficiency is associated with significantly lower haemoglobin levels throughout the peri\u2010operative period and more frequent blood transfusion. Correction of iron stores before surgery forms part of the first pillar of patient blood management. We established a pre\u2010operative anaemia clinic to aid identification and treatment of patients with iron deficiency anaemia scheduled for elective cardiac surgery. We present a retrospective observational review of our experience from January 2017 to December 2019. One\u2010hundred and ninety patients received treatment with intravenous iron, a median of 21\u00a0days before cardiac surgery. Of these, 179 had a formal laboratory haemoglobin level measured before surgery, demonstrating a median rise in haemoglobin of 8.0\u00a0g.l\n                    <jats:sup>\u20101<\/jats:sup>\n                    . Patients treated with i.v. iron demonstrated a significantly higher incidence of transfusion (60%) compared with the non\u2010anaemic cohort (22%) during the same time period, p\u00a0&lt;\u00a00.001. Significantly higher rates of new requirement for renal replacement therapy (6.7% vs. 0.6%, p\u00a0&lt;\u00a00.001) and of stroke (3.7% vs. 1.2%, p\u00a0=\u00a00.010) were also seen in this group compared with those without anaemia, although there was no significant difference in in\u2010hospital mortality (1.6% vs. 0.8%, p\u00a0=\u00a00.230). In patients where the presenting haemoglobin was less than 130\u00a0g.l\n                    <jats:sup>\u20101<\/jats:sup>\n                    , but there was no intervention or treatment, there was no difference in rates of transfusion or of complications compared with the anaemic group treated with iron. In patients with proven iron deficiency anaemia, supplementation with intravenous iron showed only a modest effect on haemoglobin and this group still had a significantly higher transfusion requirement than the non\u2010anaemic cohort. Supplementation with intravenous iron did not improve outcomes compared with patients with anaemia who did not receive intravenous iron and did not reduce peri\u2010operative risk to non\u2010anaemic levels. Questions remain regarding identification of patients who will receive most benefit, the use of concomitant treatment with other agents, and the optimum time frames for treatment in order to produce benefit in the real\u2010world setting.\n                  <\/jats:p>","DOI":"10.1111\/anae.15271","type":"journal-article","created":{"date-parts":[[2020,11,5]],"date-time":"2020-11-05T04:27:16Z","timestamp":1604550436000},"page":"629-638","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Anaemia in cardiac surgery \u2013 a retrospective review of a centre's experience with a pre\u2010operative intravenous iron\u00a0clinic"],"prefix":"10.1111","volume":"76","author":[{"given":"C.","family":"Quarterman","sequence":"first","affiliation":[{"name":"Department of Anaesthesia Liverpool Heart and Chest Hospital UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Shaw","sequence":"additional","affiliation":[{"name":"Liverpool Heart and Chest Hospital UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Hughes","sequence":"additional","affiliation":[{"name":"Liverpool Heart and Chest Hospital UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V.","family":"Wallace","sequence":"additional","affiliation":[{"name":"Liverpool Heart and Chest Hospital UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Manchester University NHS Foundation Trust UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,11,5]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"World Health Organization.Worldwide prevalence of anaemia 1993\u20132005: WHO global database on anaemia.2008.https:\/\/www.who.int\/vmnis\/anaemia\/prevalence\/summary\/anaemia_data_status_t2\/en(accessed February 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