received blood transfusion were Preoperative risk scoring; Uptake anaemic preoperatively, and also that and correlation with postoperative preoperative anaemia was associated course in a tertiary teaching with an increased length of stay. hospital We have introduced a protocol to R Foye, S Dwyer, A Baker investigate patients with preoperative Elizabeth University Hospital, anaemia by checking ferritin and Glasgow protein (CRP) levels. In cases consistent with iron deficiency, a letter will be forwarded to the patient’s GP and they will be commenced on iron Introduction supplementation. If anaemia of chronic disease is suspected, patients will be With the ever increasing demand for given intravenous iron and reviewed critical care and downstream acute on admission. beds nationally,1 methods to estimate Data are being collected on an the length of stay for patients ongoing basis following the undergoing major surgery and to allow introduction of this protocol to review appropriate planning could be a any impact on transfusion rates, length valuable bed management resource. of stay and any associated benefits Furthermore, with recent further from treating and prompting emphasis regarding the importance of investigation of preoperative anaemia. patient consent,2 being able to offer objective measures of perioperative References risk seems appropriate where Preoperative anaemia. Hans possible. One such method, the GA, Jones N 2013 Continuing Surgical Outcome Risk Tool (SORT) Education in Anaesthesia, scoring system, may prove worthwhile Critical Care & Pain in our institution for these issues; it The 2015 Annual SHOT Report takes into account the patients’ ASA, PHB Bolton-Maggs (Ed) D age, urgency and nature of the Poles et al. on behalf of the procedure, and provides a predicted Serious Hazards of Transfusion 30 day mortality.3 We sought to (SHOT) Steering Group 2016 assess how widely risk scoring was Available at being used at our institution, and how International consensus well it correlated with length of stay in statement on the peri-operative critical care, acute hospital stay and management of anaemia and rate of postoperative complications. iron deficiency. Munoz M, Acheson A et al 2017 Methods Anaesthesia Costing statement: blood Beginning May 2016, we followed one transfusion NICE 2015 hundred consecutive patients undergoing colorectal and
received blood transfusion were anaemic preoperatively, and also that preoperative anaemia was associated with an increased length of stay. We have introduced a protocol to investigate patients with preoperative anaemia by checking ferritin and protein (CRP) levels. In cases consistent with iron deficiency, a letter will be forwarded to the patient’s GP and they will be commenced on iron supplementation. If anaemia of chronic disease is suspected, patients will be given intravenous iron and reviewed on admission. Data are being collected on an ongoing basis following the introduction of this protocol to review any impact on transfusion rates, length of stay and any associated benefits from treating and prompting investigation of preoperative anaemia. References Preoperative anaemia. Hans GA, Jones N 2013 Continuing Education in Anaesthesia, Critical Care & Pain The 2015 Annual SHOT Report PHB Bolton-Maggs (Ed) D Poles et al. on behalf of the Serious Hazards of Transfusion (SHOT) Steering Group 2016 Available at International consensus statement on the peri-operative management of anaemia and iron deficiency. Munoz M, Acheson A et al 2017 Anaesthesia Costing statement: blood transfusion NICE 2015 Preoperative risk scoring; Uptake and correlation with postoperative course in a tertiary teaching hospital R Foye, S Dwyer, A Baker Elizabeth University Hospital, Glasgow Introduction With the ever increasing demand for critical care and downstream acute beds nationally,1 methods to estimate the length of stay for patients undergoing major surgery and to allow appropriate planning could be a valuable bed management resource. Furthermore, with recent further emphasis regarding the importance of patient consent,2 being able to offer objective measures of perioperative risk seems appropriate where possible. One such method, the Surgical Outcome Risk Tool (SORT) scoring system, may prove worthwhile in our institution for these issues; it takes into account the patients’ ASA, age, urgency and nature of the procedure, and provides a predicted 30 day mortality.3 We sought to assess how widely risk scoring was being used at our institution, and how well it correlated with length of stay in critical care, acute hospital stay and rate of postoperative complications. Methods Beginning May 2016, we followed one hundred consecutive patients undergoing colorectal and
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