• Syed Asad Ali
  • Abdul Ghani Soomro
  • Amir Iqbal Memon
  • Akmal Jamal Siddiqui


Background: Anaemia is the commonest haematological problem in the preoperative patients. Often itis a sign of underlying disease or associated co-morbid condition. A low haemoglobin level isassociated with an excess risk in surgical procedure and its outcome. Therefore an understanding of anycause, evaluation and any potential treatment is crucial in the preoperative setting. Our objective was todetermine prevalence, evaluation and management of preoperative anaemia in the elective generalsurgical patients. Methods: Prospective observational study in Surgical Unit-II, Liaquat UniversityHospital Jamshoro from July 2008 to June 2009. One hundred and twenty-five anaemic cases wereincluded in the study, with haemoglobin level <10 g/dl. Their age ranged from 13 to 70 years. Theywere evaluated for preoperative anaemia in relation to surgical problems and associated any co-morbidconditions. Results: Out of 830 patients during the study period, 125 patients were anaemic withhaemoglobin level 2.1–9.9 g/dl. Fifty-six (44.8%) were male and 69 (55.2%) were female, and 68.5%patients were from rural areas. Hypochromic microcytic was seen in 101 (80.8%) cases. Commonestsurgical problem associated with anaemia was malignancies (27.2%) followed by haemorrhoids (20%)and tuberculosis of abdomen (14.4%). Majority of patients (52%) were managed on oral ironsupplements while 48% received blood transfusions.Keywords: Pre-operative, Anaemia, causes, evaluation, management, malignancy, haemorrhoids


Khan S, Khan M, Samad K. Can Simple Preoperative

Hemoglobin Testing Screen Symptomatic Anemia in Patients

Undergoing Ambulatory in Third World Countries? Open J

Anesth 2012;2(4):150–3.

Goodnough LT, Maniatis A, Earnshaw P, Benoni G, Beris P,

Bisbe E, et al. Detection, evaluation, and management of

preoperative anaemia in the elective orthopaedic surgical patient:

NATA guidelines. Br J Anaesth 2011;106(1):13–22.

Kotze A, Carter LA, Scally AJ. Effect of a patient blood

management programme on preoperative anaemia, transfusion

rate, and outcome after primary hip or knee arthroplasty: a quality

improvement cycle. Br J Anaesth 2012;108:943–52.

Vazquez AE, Radriguez BM. Preoperative Anemia

Considerations. Anesthesiology 2013;118(1):223.

Goodnough LT, Shander A. Patient blood management.

Anesthesiology 2012;116:1367–76.

Patel MS, Carson JL. Anemia in the preoperative patient. Anesth

Clin 2009;27:751–60

Goodnough LT, Shander A, Spivak JL, Waters JH, Friedman AJ,

Carson JL, et al. Detection, Evaluation and Management of

Anemia in the Elective Surgical Patient. Anesth Analg


Spahn DR. Anemia and patient blood management in hip and

knee surgery: a systemic review of the literature, Anesthesiology


Vuille-Lessard E, Boudreault D, Girard F, Ruel M, Chagnon M,

Hardy JF. Read blood cell transfusion practice in elective

orthopedic surgery: a multicenter cohort study. Transfusion


So-Osman C, Nelissen R, Brand R, Brand A, Stiggelbout AM.

Postoperative anemia after joint replacement surgery is no related

to quality of life during the first two weeks postoperatively.

Transfusion 2011;51(1):71–81.

Busija L, Pausenberger E, Haines TP, Haymes S, Buchbinder R,

Osborne RH. Adult measures of general health and health-related

quality of life: Medical Outcomes Study Short Form 36-Item

(SF-36) and Short Form 12-Item (SF-12) Health Surveys,

Nottingham Health Profile (NHP), Sickness Impact Profile (SIP),

Medical Outcomes Study Short Form 6D (SF-6D), Health

Utilities Index Mark 3 (HUI3), Quality of Well-Being Scale

(QWB), and Assessment of Quality of Life (AQoL). Arthritis

Care Res 2011;63(Suppl 11):S383–412.

Carson JL, Terrin ML, Noveck H, Sanders DW, Chaitman BR,

Rhoads GG, et al. Liberal or restrictive transfusion in high-risk

patients after hip surgery. N Engl J Med 2011;365(26):2453–62.

Lee SW, Kang YA, Yoon YS, Um SW, Lee SM, Yoo CG, et al.

The prevalence and evaluation of anemia associated with

tuberculosis. J Korean Med Sci 2006;21(6):1028–32.

Knight K, Wade S, Balducci L. Prevalence and outcomes of

anemia in cancer: a systematic review of the literature. Am J Med

;116(Suppl 7A):11S–26S.

Kluiber RM, Wolff BG. Evaluation of anemia caused by

hemorrhoidal bleeding, Dis Colon Rectum 1994;37(10):1006–7.

Lipschitz DA, Cook JD, Finch CA. A Clinical Evaluation of

Serum Ferritin as an Index of Iron Stores. N Engl J Med


Cormier-Lavoie A, Ruel M, Sylvestre MP, Hard JF. Effect of

postoperative anemia on functional outcomes and quality of life

after hip and knee arthoplasties: a long term follow-up.

F1000Research 2013;2:61.

Karkouti K, Wijeysundera DN, Beattie WS. Risk associated with

preoperative anemia in cardiac surgery: a multicenter cohort

study. Circulation. 2008;29;117(4):478–84.



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