Anemia Clinical Trial
Official title:
Evaluation of a Clinical Decision Support System for Anemia Management in Pre-operative Care: Feasibility & Validation Study
Anemia need to be diagnosed and treated, following several guidelines. However, the
complexity of these recommendations leads to low compliance and to unnecessary and harmful
per- and postoperative blood transfusion.
In order to improve practices and regarding the complexity of the guidelines, the latest
European Consensus Conference recommends the use of decision support systems for the
management of preoperative anemia.
The World Health Organization defines anemia as a hemoglobin level of less than 13 g/dL in
adult men and less than 12 g/dL in women.
The cause of these anemias is most often deficient with 17% iron deficiency. This deficiency
is related to age, inflammatory diseases, blood loss, and absorption disorders mainly. Anemia
must be diagnosed preoperatively and treated.
To reduce transfusion in the perioperative period there are various possibilities: increase
of the preoperative erythrocyte mass, reduction of losses, use of the blood that has been
applied.
The impact of these preoperative strategies can be considerable. In their work, Beattie and
al demonstrates that transfusion is associated with an increase in mortality at 90 days,
proportional to the volume transfused, with certainly a higher risk in fragile subjects. More
recently, an American registry of more than 220,000 patients showed that 30% had preoperative
anemia. This anemia not only significantly increased mortality, but all causes of comorbidity
were aggravated in an anemic patient.
However, the complexity of these recommendations leads to low compliance and to unnecessary
and harmful per- and postoperative blood transfusion.
In order to improve practices and regarding the complexity of the guidelines, the latest
European Consensus Conference recommends the use of decision support systems for the
management of preoperative anemia.
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