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| A Before and After Comparison: Taking Control of Anemia Optimization |
| Marjorie Gloff, Renee Robinson, Tyler Lang, Heather Lander University of Rochester, Rochester, NY, United States |
BACKGROUND: Perioperative anemia is a common condition associated with morbidity and mortality. Iron deficiency anemia (IDA) is a condition that can be treated with PO iron supplementation, a cheap but protracted therapy. Iron infusions are a suitable option for time-sensitive surgery, but arranging these can be logistically challenging. We situated an infusion center (IC) within the physical space of the Center for Perioperative Medicine (CPM; the CPM-IC), managed and staffed by the CPM team to decrease barriers to care. METHODS: Patients presenting to the CPM before surgery were included in this comparison. Those presenting before the CPM-IC opened (March 2020-July 2023) served as the control and CPM-IC patients (September 2023-November 2023) as the intervention group. Patients with a type and screen requested by the blood bank or surgeon, a history of anemia without labs in the prior 3 months, a refusal of transfusions, or a requested consultation for anemia had a point-of-care (POC) hemoglobin (Hgb) obtained at CPM. If the POC-Hgb £ 12 g/dL, an anemia panel was obtained and if diagnosed with IDA, the patient was offered IV iron, pending insurance authorization. RESULTS: 383 patients were in the control group and 49% (190) were diagnosed with IDA. Of those, 20% (38) received complete treatment, 24.7% (47) received partial treatment (insufficient time to treat), and 2 received partial treatment (patient reasons). In our intervention group, 47 patients met the criteria, of which 44.7% (21) were diagnosed with IDA. Of those, 38% (8) received complete treatment, 33% (7) patients received partial treatment (insufficient time to treat), 3 were excluded for medical reasons, and 2 were excluded due to insurance. CONCLUSIONS: Opening the CPM-IC increased access to care for IV iron infusions and therefore the timely treatment of IDA, allowing a higher percentage of patients to receive full optimization therapy before surgery. |