{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T04:27:03Z","timestamp":1769574423861,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T00:00:00Z","timestamp":1611878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"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                    Cardiac surgical patients with anaemia experience increased morbidity and mortality. Iron deficiency is the most common cause of pre\u2010operative anaemia in this group. We designed and implemented the Cardiff Pathway, a pre\u2010assessment and treatment pathway to identify cardiac surgical patients with anaemia and iron deficiency. Patients identified with anaemia and\/or iron deficiency (Hb &lt; 130\u00a0g.l\n                    <jats:sup>\u20101<\/jats:sup>\n                    and ferritin &lt; 100\u00a0\u03bcg.l\n                    <jats:sup>\u20101<\/jats:sup>\n                    ) were offered intravenous iron infusion 20 mg.kg\n                    <jats:sup>\u20101<\/jats:sup>\n                    pre\u2010operatively. Treatment success was defined as Hb \u2265 130g.l\n                    <jats:sup>\u20101<\/jats:sup>\n                    on the day of surgery. We analysed data from 447 patients: 300 (67%) were not anaemic; 75 (17%) were anaemic and treated with intravenous iron; and 72 (16%) were anaemic and not treated. Haemoglobin concentration increased in successfully treated anaemic patients by a mean (95%CI) of 17 (13\u201321) g.l\n                    <jats:sup>\u20101<\/jats:sup>\n                    and they received a median (IQR [range]) of 0 (0\u20132 [0\u201315]) units of blood peri\u2010operatively. Transfusion was avoided in 54% of the successfully treated anaemic patients, which was significantly more than the unsuccessfully treated anaemic (22%, p = 0.005) and untreated anaemic (28%, p = 0.018) patients and similar to non\u2010anaemic patients who received a median (IQR [range] of 0 (0\u20131 [0\u201316])) units of blood and, 63% avoided transfusion). Mean (95%CI) Hb fell between pre\u2010assessment and surgery in the untreated anaemic (\u20102 (0 to \u20104) g.l\n                    <jats:sup>\u20101<\/jats:sup>\n                    ) and non\u2010anaemic groups (\u20102 (\u20101 to \u20103) g.l\n                    <jats:sup>\u20101<\/jats:sup>\n                    ). Twenty\u2010one (7%) of the non\u2010anaemic group became newly anaemic waiting for surgery. The Cardiff Pathway reliably identified patients with anaemia and iron deficiency. Anaemic patients who had their Hb restored to normal after treatment required less blood peri\u2010operatively and over half of them required no transfusion at all.\n                  <\/jats:p>","DOI":"10.1111\/anae.15396","type":"journal-article","created":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T11:22:30Z","timestamp":1611919350000},"page":"639-646","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Observational study of pre\u2010operative intravenous iron given to anaemic patients before elective cardiac surgery"],"prefix":"10.1111","volume":"76","author":[{"given":"C. R.","family":"Evans","sequence":"first","affiliation":[{"name":"University Hospital of Wales Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Jones","sequence":"additional","affiliation":[{"name":"University Hospital of Wales Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Phillips","sequence":"additional","affiliation":[{"name":"University Hospital of Wales Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Greene","sequence":"additional","affiliation":[{"name":"Department of Statistics Cardiff University Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Phillips","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery University Hospital of Wales Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Morris\u2010Clarke","sequence":"additional","affiliation":[{"name":"University Hospital of Wales Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,1,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61381-0"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2011.06819.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2012.12.021"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeu098"},{"key":"e_1_2_6_6_1","unstructured":"World Health Organization.Vitamin and mineral nutrition information system (VMNIS) haemoglobin concentrations for the diagnosis of anaemia and assessment of severity.2011.https:\/\/www.who.int\/vmnis\/indicators\/haemoglobin\/en\/(accessed 28\/06\/2020)."},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13773"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2013.06.030"},{"key":"e_1_2_6_9_1","first-page":"1","article-title":"The impact of anaemia and intravenous iron replacement therapy on outcomes in cardiac surgery","volume":"47","author":"Hogan M","year":"2014","journal-title":"European Journal of Cardiothoracic Surgery"},{"key":"e_1_2_6_10_1","first-page":"28","article-title":"Patient blood management and perioperative anaemia","volume":"17","author":"Thakrar SV","year":"2017","journal-title":"British Journal of Anaesthesia Education"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2014-305856"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2019.09.016"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminhematol.2009.06.001"},{"key":"e_1_2_6_14_1","first-page":"390","article-title":"Iron homeostasis and perioperative management of iron deficiency","volume":"19","author":"Cleland SR","year":"2019","journal-title":"British Journal of Anaesthesia Education"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.12903"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.03.058"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.1446"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(02)03766-9"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2018.03.109"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2018.03.051"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2018.03.082"},{"key":"e_1_2_6_22_1","unstructured":"National Institute for Health and Care Excellence.Blood transfusion [NG24]. Recommendation 1.1.3.https:\/\/www.nice.org.uk\/guidance\/ng24\/chapter\/recommendations#alternatives\u2010to\u2010blood\u2010transfusion\u2010for\u2010patients\u2010having\u2010surgery\u20102(accessed 21\/11\/2019)."},{"key":"e_1_2_6_23_1","unstructured":"PharmacosmosUK Limited.Monofer\u00ae 100mg\/ml solution for injection\/infusion.https:\/\/www.medicines.org.uk\/emc\/medicine\/23669(accessed 05\/07\/2020)."},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14466"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13423"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2012.2449"},{"key":"e_1_2_6_27_1","first-page":"194","article-title":"Impact of minimum haematocrit during cardiopulmonary bypass on mortality in patients undergoing coronary artery surgery","volume":"96","author":"Fang WC","year":"1997","journal-title":"Circulation"},{"key":"e_1_2_6_28_1","first-page":"38","article-title":"Influence of haemoglobin concentration after extracorporeal circulation on mortality and morbidity in patients undergoing\u00a0cardiac surgery","volume":"81","author":"Hardy JF","year":"1998","journal-title":"British Journal of Anaesthesia."},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(01)00580-2"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32555-8"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31539-7"}],"container-title":["Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anae.15396","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/anae.15396","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anae.15396","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T19:02:33Z","timestamp":1761678153000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1111\/anae.15396"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,29]]},"references-count":30,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1111\/anae.15396"],"URL":"https:\/\/doi.org\/10.1111\/anae.15396","archive":["Portico"],"relation":{},"ISSN":["0003-2409","1365-2044"],"issn-type":[{"value":"0003-2409","type":"print"},{"value":"1365-2044","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,29]]},"assertion":[{"value":"2020-12-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-01-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}