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Termebafzadeh Yazdi M J, Javadzadeh Shahshahani H. Relative Frequency of Preoperative Anemia in Elective Surgical Candidates at Hospitals Affiliated to Yazd Islamic Azad University. bloodj 2025; 22 (2) :160-167
URL: http://bloodjournal.ir/article-1-1588-en.html
Relative Frequency of Preoperative Anemia in Elective Surgical Candidates at Hospitals Affiliated to Yazd Islamic Azad University
Mohammad Javad Termebafzadeh Yazdi , Hayedeh Javadzadeh Shahshahani *
Keywords: Anemia, Surgery, Red Blood Cells, Transfusion
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   References:
  1. Lasocki S, Krauspe R, von Heymann C, Mezzacasa A, Chainey S, Spahn DR. PREPARE: the prevalence of perioperative anaemia and need for patient blood management in elective orthopaedic surgery. Eur J Anaesthesiol 2015; 32(6): 160-7. [DOI:10.1097/EJA.0000000000000202] [PMID]
  2. Gelebo KG, Neme D, Destaw B, Aweke Z, Kasa SM. The effect of preoperative anemia on perioperative outcomes among patients undergoing emergency surgery: A multicenter prospective cohort study. Heliyon 2023; 9(7): e17804. [DOI:10.1016/j.heliyon.2023.e17804] [PMID] []
  3. Muñoz M, Gómez-Ramírez S, Campos A, Ruiz J, Giancarlo M. Pre-operative anaemia: prevalence, consequences and approaches to management. Blood Transfus 2015; 13(3): 370-9.
  4. Harris AB, Badin D, Hegde V, Oni JK, Sterling RS, Khanuja HS. Preoperative Anemia is an Independent Risk Factor for Increased Complications and Mortalities After Total Knee Arthroplasty Regardless of Postoperative Transfusions. J Arthroplasty 2023; 38(7 Suppl 2): S177-S181. [DOI:10.1016/j.arth.2023.01.042] [PMID]
  5. Zhang FQ, Yang YZ, Li PF, Ma GR, Zhang AR, Zhang H, et al. Impact of preoperative anemia on patients undergoing total joint replacement of lower extremity: a systematic review and meta-analysis. J Orthop Surg Res 2024; 19(1): 249. [DOI:10.1186/s13018-024-04706-y] [PMID] []
  6. Musallam KM, Tamim HM, Richards T, Spahn DR, Rosendaal FR, Habbal A, et al. Preoperative anaemia and postoperative outcomes in non-cardiac surgery: a retrospective cohort study. Lancet 2011; 378(9800): 1396-407. [DOI:10.1016/S0140-6736(11)61381-0] [PMID]
  7. Cochran ED, Jacobson JC, Machchhar A, Qiao J, Chung DH. Perioperative Blood Transfusion and Infectious Complications Among Pediatric Patients with Cancer. Children (Basel) 2025; 12(2): 160. [DOI:10.3390/children12020160] [PMID] []
  8. Hamilton ZA, Carbonella J, Siddiqui S, Al-Hammadi N, Hinyard L. Infectious complications associated with perioperative blood transfusion in partial or radical nephrectomy. Urol Oncol 2021; 39(2): 134.e17-134.e26. [DOI:10.1016/j.urolonc.2020.10.079] [PMID]
  9. Schiergens TS, Rentsch M, Kasparek MS, Frenes K, Jauch KW, Thasler WE. Impact of perioperative allogeneic red blood cell transfusion on recurrence and overall survival after resection of colorectal liver metastases. Dis Colon Rectum 2015; 58(1): 74-82. [DOI:10.1097/DCR.0000000000000233] [PMID]
  10. Muñoz M, Gómez-Ramírez S, Campos A, Ruiz J, Giancarlo M. Pre-operative anaemia: prevalence, consequences and approaches to management. Blood Transfus 2015; 13(3): 370-9.
  11. Kim C, Connell H, McGeorge A, Hu R. Prevalence of preoperative anaemia in patients having first-time cardiac surgery and its impact on clinical outcome. A retrospective observational study. Perfusion 2015; 30: 277-83. [DOI:10.1177/0267659114542457] [PMID]
  12. Gross I, Seifert B, Hofmann A, Spahn DR. Patient blood management in cardiac surgery results in fewer transfusions and better outcome. Transfusion 2015; 55(5): 1075-81. [DOI:10.1111/trf.12946] [PMID]
  13. Cambronero D, Matoses-Jaén S, García-Claudio N, García-Gregorio N. Preoperative management of anemia in oncologic surgery. Molins Espinosa J 2015; l: 45-51. [DOI:10.1016/S0034-9356(15)30007-4] [PMID]
  14. von Heymann C, Krämer M:Transfusion medicine: does treatment of anemia reduce costs to the national health system. 2011; 46(10): 648-653. [DOI:10.1055/s-0031-1291942] [PMID]
  15. Mendez-Pino L, Zorrilla-Vaca A, Hepner DL. Management of Preoperative Anemia. Anesthesiol Clin 2024; 42(1): 65-73. [DOI:10.1016/j.anclin.2023.09.002] [PMID]
  16. Kloeser R, Buser A, Bolliger D. Treatment Strategies in Anemic Patients before Cardiac Surgery. J Cardiothorac Vasc Anesth 2023; 37(2): 266-275. [DOI:10.1053/j.jvca.2022.09.085] [PMID]
  17. Charbonneau H, Savy S, Savy N, Pasquié M. Comprehensive perioperative blood management in patients undergoing elective bypass cardiac surgery: Benefit effect of health care education and systematic correction of iron deficiency and anemia on red blood cell transfusion. J Clin Anesth 2024; 98: 111560. [DOI:10.1016/j.jclinane.2024.111560] [PMID]
  18. Muñoz M, Acheson AG, Auerbach M, Besser M, Habler O, Kehlet H, et al. International consensus statement on the peri-operative management of anaemia and iron deficiency. Anaesthesia 2017; 72(2): 233-247. [DOI:10.1111/anae.13773] [PMID]
  19. Amponsah G , Charwudzi A. Preoperative Anaemia and Associated Postoperative Outcomes in Noncardiac Surgery Patients in Central Region of Ghana. Anesthesiol Res Pract 2017; 2017: 1-10. [DOI:10.1155/2017/7410960] [PMID] []
  20. Munting KE, Klein AA. Optimisation of pre-operative anaemia in patients before elective major surgery - why, who, when and how? Anaesthesia 2019; 74(1): 49-57. [DOI:10.1111/anae.14466] [PMID]
  21. Abdullah HR, Sim YE, Hao Y, Lin GY, Liew GHC, Lamoureux EL, et al. Association between preoperative anaemia with length of hospital stay among patients undergoing primary total knee arthroplasty in Singapore: a single-centre retrospective study. BMJ Open 2017; 7(6): e016403. [DOI:10.1136/bmjopen-2017-016403] [PMID] []
  22. Auron M, Duran Castillo MY. Preoperative anemia optimization: role of iron supplementation. Journal of Xiangya Medicine 2018; 3: 37. [DOI:10.21037/jxym.2018.09.05]




Relative Frequency of Preoperative Anemia in Elective
 Surgical Candidates at Hospitals Affiliated to Yazd
Islamic Azad University
 ‎
Mohammad Javad Termebafzadeh Yazdi1, Hayedeh Javadzadeh Shahshahani2,3


1Islamic Azad University of Yazd, Ali ibn Abitaleb Medical School, Yazd, Iran
2Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
3Yazd Blood Transfusion Center, Yazd, Iran

Received: 2025/07/15
Accepted: 2025/07/29
 





    https://doi.org/10.18502/avr.v34i2.18052

    



Citation:
Termebafzadeh Yazdi M.J, Javadzadeh Shahshahani H. Relative Frequency of Preoperative Anemia in Elective  Surgical Candidates at Hospitals Affiliated to Yazd Islamic Azad University . J Iran Blood Transfus. 2025: 22 (2) : 160-167
    



Correspondence: Javadzadeh Shahshahani H., Associate Professor of Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine.
Postal Code: 8915913971, Yazd, Iran.
Tel: (+9835) 38249517         
E-mail: h.javadzadeh@tmi.ac.ir		 A B S T R A C T
Background and Objectives
Diagnosis and management of preoperative anemia are essential for improving in surgical outcome and minimizing blood transfusion risks. The aim of this study was to investigate the anemia among patients scheduled for elective surgeries at two hospitals affiliated to Yazd Islamic Azad University.
Materials and Methods
In this cross-sectional study, 400 patients admitted for elective surgery were evaluated. Demographic and clinical data, including age, sex, type of surgery, number of transfused blood units, ward, anemia, hemoglobin levels, and the duration of hospital stay, were collected using a checklist. Statistical analyses were performed by SPSS version 22, using T-Test, ANOVA, and Chi-square tests.
Results
Of the 400 patients, 101 (25%) were males and 299 (75%) females with a mean age of 36.23±12.78 years. The average hemoglobin level was 14.57±1.78 g/dL in males and 12.46±1.43 g/dL in females. The frequency of preoperative anemia was 27.8%. Anemia was more frequent in females (31.1%) compared to males (17.8%) (OR = 2.08; 95% CI: 1.18–3.66; p = 0.01). The highest anemia rates were observed in the orthopedic (45.5%) and gynecology (32.5%) wards. Anemia was notably common among patients under going hip replacement and hysterectomy procedures (p= 0.012). Blood Transfusion was administered to 18 patients (4.5%). Anemic patients received significantly more blood units (for males: p= 0.047, for females: p< 0.001). There was a significant relationship between the average hemoglobin levels before and after RBC transfusion (p= 0.013). 
Conclusions 
The findings showed that nearly one-third of elective surgical patients suffered from anemia prior to anemia, which increase the likelihood of receiving blood transfusion. Early detection and treatment of anemia before surgery may reduce blood transfusion rates and improve surgical outcomes.
Key words: Anemia, Surgery, Red Blood Cells, Transfusion
Copyright © 2025 Journal of Iranian Blood Transfusion, Published by Blood Transfusion Research Center.
This work is licensed under a Creative Common Attribution-Non Commercial 4.0 International license.



 
Type of Study: Research | Subject: Blood transfusion medicine
References
1. Lasocki S, Krauspe R, von Heymann C, Mezzacasa A, Chainey S, Spahn DR. PREPARE: the prevalence of perioperative anaemia and need for patient blood management in elective orthopaedic surgery. Eur J Anaesthesiol 2015; 32(6): 160-7. [DOI:10.1097/EJA.0000000000000202] [PMID]
2. Gelebo KG, Neme D, Destaw B, Aweke Z, Kasa SM. The effect of preoperative anemia on perioperative outcomes among patients undergoing emergency surgery: A multicenter prospective cohort study. Heliyon 2023; 9(7): e17804. [DOI:10.1016/j.heliyon.2023.e17804] [PMID] []
3. Muñoz M, Gómez-Ramírez S, Campos A, Ruiz J, Giancarlo M. Pre-operative anaemia: prevalence, consequences and approaches to management. Blood Transfus 2015; 13(3): 370-9.
4. Harris AB, Badin D, Hegde V, Oni JK, Sterling RS, Khanuja HS. Preoperative Anemia is an Independent Risk Factor for Increased Complications and Mortalities After Total Knee Arthroplasty Regardless of Postoperative Transfusions. J Arthroplasty 2023; 38(7 Suppl 2): S177-S181. [DOI:10.1016/j.arth.2023.01.042] [PMID]
5. Zhang FQ, Yang YZ, Li PF, Ma GR, Zhang AR, Zhang H, et al. Impact of preoperative anemia on patients undergoing total joint replacement of lower extremity: a systematic review and meta-analysis. J Orthop Surg Res 2024; 19(1): 249. [DOI:10.1186/s13018-024-04706-y] [PMID] []
6. Musallam KM, Tamim HM, Richards T, Spahn DR, Rosendaal FR, Habbal A, et al. Preoperative anaemia and postoperative outcomes in non-cardiac surgery: a retrospective cohort study. Lancet 2011; 378(9800): 1396-407. [DOI:10.1016/S0140-6736(11)61381-0] [PMID]
7. Cochran ED, Jacobson JC, Machchhar A, Qiao J, Chung DH. Perioperative Blood Transfusion and Infectious Complications Among Pediatric Patients with Cancer. Children (Basel) 2025; 12(2): 160. [DOI:10.3390/children12020160] [PMID] []
8. Hamilton ZA, Carbonella J, Siddiqui S, Al-Hammadi N, Hinyard L. Infectious complications associated with perioperative blood transfusion in partial or radical nephrectomy. Urol Oncol 2021; 39(2): 134.e17-134.e26. [DOI:10.1016/j.urolonc.2020.10.079] [PMID]
9. Schiergens TS, Rentsch M, Kasparek MS, Frenes K, Jauch KW, Thasler WE. Impact of perioperative allogeneic red blood cell transfusion on recurrence and overall survival after resection of colorectal liver metastases. Dis Colon Rectum 2015; 58(1): 74-82. [DOI:10.1097/DCR.0000000000000233] [PMID]
10. Muñoz M, Gómez-Ramírez S, Campos A, Ruiz J, Giancarlo M. Pre-operative anaemia: prevalence, consequences and approaches to management. Blood Transfus 2015; 13(3): 370-9.
11. Kim C, Connell H, McGeorge A, Hu R. Prevalence of preoperative anaemia in patients having first-time cardiac surgery and its impact on clinical outcome. A retrospective observational study. Perfusion 2015; 30: 277-83. [DOI:10.1177/0267659114542457] [PMID]
12. Gross I, Seifert B, Hofmann A, Spahn DR. Patient blood management in cardiac surgery results in fewer transfusions and better outcome. Transfusion 2015; 55(5): 1075-81. [DOI:10.1111/trf.12946] [PMID]
13. Cambronero D, Matoses-Jaén S, García-Claudio N, García-Gregorio N. Preoperative management of anemia in oncologic surgery. Molins Espinosa J 2015; l: 45-51. [DOI:10.1016/S0034-9356(15)30007-4] [PMID]
14. von Heymann C, Krämer M:Transfusion medicine: does treatment of anemia reduce costs to the national health system. 2011; 46(10): 648-653. [DOI:10.1055/s-0031-1291942] [PMID]
15. Mendez-Pino L, Zorrilla-Vaca A, Hepner DL. Management of Preoperative Anemia. Anesthesiol Clin 2024; 42(1): 65-73. [DOI:10.1016/j.anclin.2023.09.002] [PMID]
16. Kloeser R, Buser A, Bolliger D. Treatment Strategies in Anemic Patients before Cardiac Surgery. J Cardiothorac Vasc Anesth 2023; 37(2): 266-275. [DOI:10.1053/j.jvca.2022.09.085] [PMID]
17. Charbonneau H, Savy S, Savy N, Pasquié M. Comprehensive perioperative blood management in patients undergoing elective bypass cardiac surgery: Benefit effect of health care education and systematic correction of iron deficiency and anemia on red blood cell transfusion. J Clin Anesth 2024; 98: 111560. [DOI:10.1016/j.jclinane.2024.111560] [PMID]
18. Muñoz M, Acheson AG, Auerbach M, Besser M, Habler O, Kehlet H, et al. International consensus statement on the peri-operative management of anaemia and iron deficiency. Anaesthesia 2017; 72(2): 233-247. [DOI:10.1111/anae.13773] [PMID]
19. Amponsah G , Charwudzi A. Preoperative Anaemia and Associated Postoperative Outcomes in Noncardiac Surgery Patients in Central Region of Ghana. Anesthesiol Res Pract 2017; 2017: 1-10. [DOI:10.1155/2017/7410960] [PMID] []
20. Munting KE, Klein AA. Optimisation of pre-operative anaemia in patients before elective major surgery - why, who, when and how? Anaesthesia 2019; 74(1): 49-57. [DOI:10.1111/anae.14466] [PMID]
21. Abdullah HR, Sim YE, Hao Y, Lin GY, Liew GHC, Lamoureux EL, et al. Association between preoperative anaemia with length of hospital stay among patients undergoing primary total knee arthroplasty in Singapore: a single-centre retrospective study. BMJ Open 2017; 7(6): e016403. [DOI:10.1136/bmjopen-2017-016403] [PMID] []
22. Auron M, Duran Castillo MY. Preoperative anemia optimization: role of iron supplementation. Journal of Xiangya Medicine 2018; 3: 37. [DOI:10.21037/jxym.2018.09.05]
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