PREPARE: the prevalence of perioperative anaemia and need for patient blood management in elective orthopaedic surgery: A multicentre, observational study.

In this observational, multicentre study, the authors investigated the prevalence of pre- and postoperative anaemia as well as perioperative anaemia management practices among 1534 patients undergoing orthopaedic surgery at 17 centres in 6 European countries. Results were stratified according to whether centres had an institutional protocol to treat or prevent preoperative anaemia (PBM centres).

The prevalence of preoperative anaemia was 14%, but almost 86% of patients developed postoperative anaemia. Patients who were anaemic preoperatively had a higher rate of postoperative complications (37% vs. 22%) and longer hospital stays (11.7 vs. 8.8 days). The multivariate analysis showed that longer hospital stays were independently associated with receipt of red blood cell transfusion (OR 2.07) and enrollment in a non-PBM centre (OR 1.88). The authors comment that few patients received preoperative anaemia treatment with iron and erythropoiesis-stimulating agents. The transfusion rate in non-PBM centres was almost twice as high as in PBM centres (21% vs. 11.75%).

It appears from this study that PBM measures to avoid transfusion are still underused in Europe.

– Elvira Bisbe

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