Managing Preoperative Anemia: Evolving Concepts and Strategies for Improving Patient Outcomes

Abstract Anemia is the most common hematologic disease and is defined by the World Health Organization as a condition in which the number of red blood cells and consequently oxygen-carrying capacity is insufficient to meet physiologic needs of the body. Anemia can occur throughout the perioperative period and important clinical consequences. Preoperative anemia is usually regarded as no more than a surrogated marker of patient’s physical status, and it is not always adequately addressed before surgery. Postoperative anemia is a common event and occurs in 80-90% of patients who have undergone major surgery. This manuscript discusses detection and management of preoperative anemia, the three pillars of patient blood management, perioperative anemia management, and risk stratification for anemia in the surgical setting.