Pre-Operative Anaemia: Should We Worry?

This chapter presents literature on pre‐operative anaemia. Few clinicians are aware of the high prevalence of pre‐operative anaemia in patients scheduled to undergo surgery. Surgeons, anaesthetists and patients worry about postoperative complications. Without blood transfusion the impact of a low preoperative Hb on postoperative mortality depends on the Hb concentration at the start of surgery, presence or absence of cardiovascular disease, and the magnitude of the blood loss. The commonest cause of anaemia worldwide is iron deficiency secondary to malnutrition or parasitic infestation. A common approach to the evaluation of anaemia is to subdivide the condition into microcytic, normocytic and macrocytic types according to the mean cell volume (MCV). The efficacy of treating pre‐operative anaemia must be measured by recording, at the very least, pre‐treatment and post‐treatment Hb, the time interval between treatment and surgery, the peri‐operative use of blood products, length of hospital stay, major complications and mortality.