{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T02:03:29Z","timestamp":1790129009645,"version":"4.0.1"},"reference-count":12,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"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":["Vox Sanguinis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>\n                      Preoperative anemia (PA) and thrombocytopenia (PT) are associated with increased perioperative morbidity and mortality. We implemented an automated flowchart integrating automated diagnostic reflex testing with electronic notifications to the preoperative unit (POU) triggered by hemoglobin (Hb) concentration &lt;10\u2009g\/dL and\/or platelet count (PLT) &lt;75\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>In this retrospective observational study, compliance and management of PA and PT were evaluated after routine implementation of the flowchart.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The flowchart was initiated for 41 patients (1.5% of POU orders). Hb was 8\u201310\u2009g\/dL in 34 patients and &lt;8\u2009g\/dL in four patients. Three patients had PLT &lt;75\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L with Hb &gt;10\u2009g\/dL. At least one recommended action was undertaken in 88%, most frequently including documentation in the electronic medical record, communication with treating clinicians or referral to a hematologist. Etiology was established in 25 patients, with isolated iron deficiency as the most common cause of PA. Preoperative correction of anemia was performed in 26\/41 patients and was primarily non\u2010transfusion\u2010based. Seven patients received transfusion therapy. Surgery was postponed in one case.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A high compliance with the automated flowchart was observed and guided diagnostic and therapeutic interventions. Further optimization may improve standardized perioperative management of PA and PT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/vox.70370","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T01:04:28Z","timestamp":1790125468000},"source":"Crossref","is-referenced-by-count":0,"title":["Implementation of a patient blood management optimization flowchart for preoperative anemia using automated alerts: An 8\u2010month follow\u2010up"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9095-9607","authenticated-orcid":false,"given":"Bas","family":"Calcoen","sequence":"first","affiliation":[{"name":"Department of Laboratory Hematology AZ Sint\u2010Jan Hospital A.V.  Bruges Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4320-5343","authenticated-orcid":false,"given":"Morane","family":"Swennen","sequence":"additional","affiliation":[{"name":"Department of Laboratory Hematology AZ Sint\u2010Jan Hospital A.V.  Bruges Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgit","family":"Loveniers","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care AZ Sint\u2010Jan Hospital A.V.  Bruges Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann\u2010Marie","family":"Matthys","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care AZ Sint\u2010Jan Hospital A.V.  Bruges Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Vauterin","sequence":"additional","affiliation":[{"name":"Department of ENT Diseases AZ Sint\u2010Jan Hospital A.V.  Bruges Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Van","family":"Droogenbroeck","sequence":"additional","affiliation":[{"name":"Department of Clinical Hematology AZ Sint\u2010Jan Hospital A.V.  Bruges Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Devos","sequence":"additional","affiliation":[{"name":"Department of Laboratory Hematology AZ Sint\u2010Jan Hospital A.V.  Bruges Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6788-1506","authenticated-orcid":false,"given":"Jan","family":"Emmerechts","sequence":"additional","affiliation":[{"name":"Department of Laboratory Hematology AZ Sint\u2010Jan Hospital A.V.  Bruges Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2264-7302","authenticated-orcid":false,"given":"Barbara","family":"Cauwelier","sequence":"additional","affiliation":[{"name":"Department of Laboratory Hematology AZ Sint\u2010Jan Hospital A.V.  Bruges Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1016\/j.htct.2022.06.001","article-title":"Targeting patient blood management's first pillar: a multicentric retrospective study on preoperative anemia","volume":"45","author":"Carvalho Duarte G","year":"2023","journal-title":"Hematol Transfus Cell Ther"},{"key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1093\/bja\/aeu098","article-title":"Preoperative anaemia is associated with poor clinical outcome in non\u2010cardiac surgery patients","volume":"113","author":"Baron DM","year":"2014","journal-title":"Br J Anaesth"},{"key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1002\/bjs.9861","article-title":"Meta\u2010analysis of the association between preoperative anaemia and mortality after surgery","volume":"102","author":"Fowler AJ","year":"2015","journal-title":"Br J Surg"},{"key":"e_1_2_9_5_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0212191","article-title":"Platelet count abnormalities and peri\u2010operative outcomes in adults undergoing elective, non\u2010cardiac surgery","volume":"15","author":"Weil IA","year":"2019","journal-title":"PLoS One"},{"key":"e_1_2_9_6_1","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1213\/ANE.0000000000005347","article-title":"The prevalence and clinical significance of preoperative thrombocytopenia in adults undergoing elective surgery: an observational cohort study","volume":"132","author":"Matzek LJ","year":"2021","journal-title":"Anesth Analg"},{"key":"e_1_2_9_7_1","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.amjmed.2013.09.017","article-title":"Impact of more restrictive blood transfusion strategies on clinical outcomes: a meta\u2010analysis and systematic review","volume":"127","author":"Salpeter SR","year":"2014","journal-title":"Am J Med"},{"key":"e_1_2_9_8_1","article-title":"Transfusion thresholds and other strategies for guiding red blood cell transfusion","volume":"10","author":"Carson JL","year":"2025","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_9_1","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1097\/SLA.0000000000005721","article-title":"Recommendations from the International Consensus Conference on Anemia Management in Surgical Patients (ICCAMS)","volume":"277","author":"Shander A","year":"2022","journal-title":"Ann Surg"},{"key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"2006","DOI":"10.1111\/trf.18383","article-title":"Patient blood management: optimizing preoperative care using automated alerts","volume":"65","author":"Swennen M","year":"2025","journal-title":"Transfusion"},{"key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"2763","DOI":"10.1111\/trf.15464","article-title":"The pillars of patient blood management: key to successful implementation","volume":"59","author":"Sullivan HC","year":"2019","journal-title":"Transfusion"},{"key":"e_1_2_9_12_1","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1111\/anae.13773","article-title":"International consensus statement on the peri\u2010operative management of anaemia and iron deficiency","volume":"72","author":"Mu\u00f1oz M","year":"2017","journal-title":"Anaesthesia"},{"key":"e_1_2_9_13_1","article-title":"Pseudothrombocytopenia due to platelet clumping: a case report and brief review of the literature","volume":"2016","author":"Tan GC","year":"2016","journal-title":"Case Rep Hematol"}],"container-title":["Vox Sanguinis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/vox.70370","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/vox.70370","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/vox.70370","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T01:04:30Z","timestamp":1790125470000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/vox.70370"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,22]]},"references-count":12,"alternative-id":["10.1111\/vox.70370"],"URL":"https:\/\/doi.org\/10.1111\/vox.70370","archive":["Portico"],"relation":{},"ISSN":["0042-9007","1423-0410"],"issn-type":[{"value":"0042-9007","type":"print"},{"value":"1423-0410","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,22]]},"article-number":"vox.70370"}}