Can pre-operative anemia be timely identified and optimized in patients awaiting primary arthroplasty surgery? A randomized clinical trial

Addressing anemia (low hemoglobin levels) pre-operatively in patients undergoing major surgery has been associated with improved outcomes by reducing complications, such as the need for blood transfusions. To improve outcomes, patients at The Ottawa Hospital with anemia are referred to the Pre-operative Blood Optimization Clinic (PBOC) for treatment. However, only a quarter of anemic patients are seen in the PBOC due to the lack of time between anemia identification and surgery, and the current resources available. This project focuses on improving anemia pre-operatively in primary hip and knee arthroplasty patients. Patients will be randomly assigned to 1) the current standard of care with an anemia test at the pre-operative assessment clinic, 2-4 weeks before surgery; or 2) the experimental group where they will undergo a test to detect anemia when they consent for surgery, 4-6 months before surgery. At this time, patients with anemia will be invited for treatment at the PBOC. This project will demonstrate whether early assessment and treatment of anemia is feasible and can be successfully integrated into practice, and whether such practice can reduce the overall anemia burden and ultimately improve patient outcomes. Primary outcome measures include recruitment rates, compliance, and changes in hemoglobin levels.

GRAMMATOPOULOS, George

Ottawa Hospital Research Institute

Intramural Research Grant Program

Ontario

$276,081