Implementation of an anaemia walk-in clinic: feasibility and preliminary data from the Orthopedic University Hospital

  • Background: Approximately one in three patients suffers from preoperative anaemia. Even though haemoglobin is measured before surgery, anaemia management is not implemented in every hospital. Objective: Here, we demonstrate the implementation of an anaemia walk-in clinic at an Orthopedic University Hospital. To improve the diagnosis of iron deficiency (ID), we examined whether reticulocyte haemoglobin (Ret-He) could be a useful additional parameter. Material and Methods: In August 2019, an anaemia walk-in clinic was established. Between September and December 2019, major orthopaedic surgical patients were screened for preoperative anaemia. The primary endpoint was the incidence of preoperative anaemia. Secondary endpoints included Ret-He level, red blood cell (RBC) transfusion rate, in-hospital length of stay and anaemia at hospital discharge. Results: A total of 104 patients were screened for anaemia. Preoperative anaemia rate was 20.6%. Intravenous iron was supplemented in 23 patients. Transfusion of RBC units per patient (1.7 ± 1.2 vs. 0.2 ± 0.9; p = 0.004) and hospital length of stay (13.1 ± 4.8 days vs. 10.6 ± 5.1 days; p = 0.068) was increased in anaemic patients compared to non-anaemic patients. Ret-He values were significantly lower in patients with ID anaemia (33.3 pg [28.6–40.2 pg]) compared to patients with ID (35.3 pg [28.9–38.6 pg]; p = 0.015) or patients without anaemia (35.4 pg [30.2–39.4 pg]; p = 0.001). Conclusion: Preoperative anaemia is common in orthopaedic patients. Our results proved the feasibility of an anaemia walk-in clinic to manage preoperative anaemia. Furthermore, our analysis supports the use of Ret-He as an additional parameter for the diagnosis of ID in surgical patients.
Author:Vanessa NeefORCiDGND, David Meisenzahl, Paul Kessler, Florian Jürgen RaimannORCiDGND, Florian PiekarskiORCiDGND, Suma Choorapoikayil, Christoph Fleege, Kai ZacharowskiORCiDGND, Patrick MeybohmORCiDGND, Andrea MeurerORCiD
Parent Title (English):Transfusion Medicine
Place of publication:Oxford [u.a.]
Document Type:Article
Date of Publication (online):2020/11/25
Date of first Publication:2020/11/25
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2022/03/15
Tag:anaemia walk-in clinic; blood transfusion; iron deficiency; orthopaedic patients; patient blood management; reticulocyte haemoglobin
Page Number:8
First Page:467
Last Page:474
Funding information: B. Braun Melsungen, CSL Behring, Fresenius Kabi, and Vifor Pharma; Pharmacosmos; Ferring; Vifor Pharma; Fresenius Kabi; CSL Behring; B. Braun Melsungen
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0