Background We assessed whether implementation of an immediate preoperative treatment in anemic patients could result in fewer perioperative packed red blood cell (PRBC) transfusions and improved outcomes in a real-world setting.

Methods From January 1, 2020, to November 31, 2022, we implemented a perioperative protocol for anemic patients (hemoglobin (Hb) level in women <11.5 g/dL, men <12.5 g/dL), which included subcutaneous erythropoietin α, intravenous Iron, and intramuscular vitamin B12 (all given preoperatively) and per os iron and folic acid given once a day postoperatively. We retrospectively compared all patients receiving the protocol to all eligible patients who were operated upon in the 4 years prior to implementation of the protocol. Primary outcome was amount of PRBC transfusions during surgery and index admission.

Results In the months after protocol implementation, 114 patients who received the treatment protocol were compared with 236 anemic patients in the 4 years prior to who did not receive the protocol. The treatment reduced total PRBC use (control group median 4 [2–7] units vs. treatment 2 [1–3] units, p < 0.0001) and the incidence of postoperative blood products transfusions (treatment group 58 patients, 50.88% vs. control group 177 patients, 75%, p < 0.0001). Hb prior to discharge was higher among the protocol group (treatment median 9 g/dL [8.3–9.5 g/dL] vs. control 8.6 g/dL [8.1–9.1 g/dL], p = 0.0081).

Conclusion Despite some differences compared with previously described protocols, the implementation of a perioperative treatment protocol for anemic patients was associated with a reduction in PRBC transfusion in a real-world setting.

背景 我们评估了对贫血患者实施术前立即治疗是否可以减少围手术期浓缩红细胞（PRBC）输注并改善现实环境中的预后。

方法 从2020年1月1日至2022年11月31日，我们对贫血患者（女性血红蛋白（Hb）水平<11.5 g/dL，男性<12.5 g/dL）实施了围手术期方案，其中包括皮下注射促红细胞生成素α、静脉注射铁剂和肌内维生素 B12（均在术前给予）以及术后每天一次口服铁剂和叶酸。我们回顾性地比较了所有接受该方案的患者与在该方案实施前 4 年内接受手术的所有符合资格的患者。主要结局是手术期间和首次入院期间 PRBC 输注量。

结果 在方案实施后的几个月内，将 114 名接受治疗方案的患者与 4 年前未接受该方案的 236 名贫血患者进行了比较。治疗减少了 PRBC 的总使用量（对照组中位数 4 [2-7] 单位 vs. 治疗组 2 [1-3] 单位，p  < 0.0001）和术后血液制品输注的发生率（治疗组 58 名患者，50.88% vs.对照组 177 名患者，75%，p  < 0.0001)。方案组出院前的 Hb 较高（治疗中位数 9 g/dL [8.3–9.5 g/dL] 对比对照组 8.6 g/dL [8.1–9.1 g/dL]，p = 0.0081 ）  。

结论 尽管与之前描述的方案相比存在一些差异，但贫血患者围手术期治疗方案的实施与现实环境中 PRBC 输注的减少相关。