Simplified diagnostic algorithm for classification of preoperative anaemia based on complete blood count and its application in elective gastrointestinal surgery

Abstract

Introduction Anaemia is associated with increased morbidity, mortality, length of stay, requirement for blood transfusion. Early differential diagnosis of anaemia may expedite treatment and outcome in the perioperative setting. The aim of our study was to create simplified diagnostic algorithm for classification of anaemia based on complete blood count and test its applicability in elective gastrointestinal surgical population. Material and methods Selected red blood cell (RBC) parameters derived from CBC test performed by the Central Laboratory of the University Clinical Centre of Medical University of Silesia, Katowice, Poland were reviewed retrospectively for the group of 442 consecutive patients scheduled for elective, high-risk (according to) GI surgery between January 2016 and August 2018. Based on pathophysiologic data we created a simplified diagnostic algorithm for classification of preoperative anaemia and applied it to the study population. Results Using the cut-off value of 130 g L-1 for both sexes, anaemia was diagnosed in 166 patients (37.5%). As many as 29 (17.5%) anaemic patients had aetiology of anaemia accurately established by using our simplified diagnostic algorithm – either iron or vitamin B12/folate deficiency. Discussion Preoperative anaemia is common in elective gastrointestinal surgery. Simplified diagnostic algorithm based solely on complete blood count parameters might be helpful in the preliminary identification of patients with iron and vitamin B12/folic acid deficiencies so haematinic supplementation can be started early.