The benefit of early identification of anemia preoperatively in patients undergoing hip and knee joint arthroplasty

AimThe primary objective of this study was to establish the frequency of preoperative anemia (Hb < 130 g/L) in patients undergoing hip and knee arthroplasty. The secondary objective was to improve anemia optimization by identifying anemia earlier in the preoperative phase.MethodsThe study was a prospective analysis of preoperative patients undergoing joint arthroplasty. A CBC was done at the first clinic visit (as opposed to the usual second visit). Patients were asked about any history of anemia. A ferritin was added if there was a history of anemia. Anemic patients were referred to the blood conservation clinic for treatment of anemia.Results782 patients were seen during the nine month study period. 365 patients were enrolled. 65% were female. The incidence of anemia was 21%. 68 patients had ferritins measured: 10 patients (15%) had iron deficiency (ferritin <30 μg/L). Overall, the transfusion rate for all procedures during the study period was 3.6% (52/1439 cases) compared to 5.1% (75/1463 cases) in the previous year.ConclusionsAnemia is common in patients undergoing hip and knee replacement surgery. Early identification of preoperative anemia allows more time for hemoglobin optimization and may contribute to fewer transfusions perioperatively.