Simplified diagnostic algorithm for classification of preoperative anaemia based on complete blood count and its application in elective gastrointestinal surgery
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Introduction: Anaemia is associated with increased morbidity, mortality, hospital length of stay, and requirement for blood transfusion. Early differential diagnosis of anaemia may expedite its treatment and improve outcomes in the perioperative setting. The aim of our study was to create a simplified diagnostic algorithm for classification of anaemia based on complete blood count and to test its applicability in an elective gastrointestinal surgical population. Material and methods: Selected clinical data and laboratory red blood cell parameters were retrieved retrospectively for the group of 442 consecutive patients scheduled for elective high-risk gastrointestinal surgery from January 2016 to August 2018. Based on pathophysiologic data we created a simplified diagnostic algorithm for classification of preoperative anaemia and applied it to the study population. Results: Using the cut-off value of 130 g L-1 for both sexes, anaemia was diagnosed in 166 patients (37.5%). As many as 29 (17.5%) anaemic patients had aetiology of anaemia accurately established using our simplified diagnostic algorithm – either iron or vitamin B12/folate deficiency. Discussion: Preoperative anaemia is common in elective gastrointestinal surgery. Simplified diagnostic algorithm based solely on complete blood count parameters is helpful in the preliminary identification of patients with iron and vitamin B12/folic acid deficiencies so haematinic supplementation can be started early in preparation for surgery.
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