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Treating Preoperative Anemia to Improve Patient Outcomes After Orthopaedic Surgery.

The Journal of the American Academy of Orthopaedic Surgeons
January 1, 1970
Satish P Shanbhag et al. (4 authors)
Journal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to highlight the importance of preoperative anemia assessment and treatment, particularly iron deficiency anemia, in orthopaedic surgery patients.

Results Summary

The study found that iron deficiency anemia, the most common type, is easily treated with iron supplementation, but the role of intravenous iron in trauma settings remains unclear. Transfusions are recommended for urgent procedures with significant blood loss if hemoglobin levels are <8 g/dL or if anemia is symptomatic.

Population

Patients undergoing orthopaedic surgery, particularly those with anemia or trauma-related blood loss.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (4)
InterventionDirectionEndpointPopulationDosageImpactClaim #
preoperative risk modification and control of comorbidities
increase
safety and outcomes
patients undergoing orthopaedic surgery
-
can maximize safety and improve outcomes
#1
iron supplementation
decrease
iron deficiency anemia
-
-
easily treated
#2
intravenous iron supplementation
no change
anemia related to acute blood loss and underlying conditions in trauma
cases of trauma
-
has not been clearly shown
#3
transfusions
increase
hemoglobin levels <8 g/dL or symptomatic anemia
patients needing urgent procedures that might involve substantial blood loss
-
should receive
#4
Abstract

For patients undergoing orthopaedic surgery, preoperative risk modification and control of comorbidities can maximize safety and improve outcomes. Anemia is common among orthopaedic patients, and its prevalence increases with patient age. Although surgeons are well versed in intraoperative blood conservation, preoperative anemia treatment is often deferred to primary care physicians, who may not understand the importance of a thorough assessment and treatment. Orthopaedic surgeons should understand the causes and treatments of anemia to advocate that patients receive appropriate preoperative care. Mean corpuscular volume and reticulocyte count can help determine the cause of anemia and assess the bone marrow's ability to produce red blood cells. These values can be used to aid in diagnosis and treatment plans. Iron deficiency anemia, the most common type, is a microcytic anemia easily treated with iron supplementation. In cases of trauma, anemia can be related to acute blood loss and underlying conditions. Fracture patterns and preexisting comorbidities should be assessed. The role of intravenous iron supplementation in this setting has not been clearly shown. Patients needing urgent procedures that might involve substantial blood loss should receive transfusions if they have hemoglobin levels <8 g/dL or symptomatic anemia.

Medical Subject Headings (MeSH)
AnemiaErythrocyte TransfusionHumansIronOrthopedic ProceduresPreoperative CareTreatment Outcome
Study Links
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality60/10
Citation Metrics
Total Citations9
Citations/Year1.5
Relative Citation Ratio0.73
NIH Percentile39%
Research Impact Scores
APT Score0.50
Weight Score1.39
Normalized Score0.62
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