• POSTVenTT Study Collaborative.
• Med. J. Aust. 2022 Nov 7; 217 (9): 487493487-493.

ObjectivesTo assess the prevalence and management of anaemia in patients undergoing major abdominal surgery, and the influence of guideline adherence on patient outcomes.DesignProspective observational cohort study.Setting56 hospitals in Australia and New Zealand.ParticipantsPeople aged 18 years or more who underwent major abdominal surgery during two 2-week periods in July 2021.Main Outcome MeasuresProportions of patients managed according to Australian National Blood Authority patient blood management guidelines.Secondary Outcomesanaemia prevalence, post-operative complications, length of hospital stay, re-admission within 30 days of discharge.ResultsData were available for 2730 eligible patients (mean age, 56.7 years; SD, 17.3 years), including 1558 women (57.1%). Haemoglobin levels prior to surgery were documented for 2461 of 2727 patients (90.2%), 689 of whom had anaemia (28.0%). Pre-operative anaemia assessment and management were associated with lower likelihood of intra-operative (adjusted odds ratio [aOR], 0.33; 95% CI, 0.19-0.57) and post-operative blood transfusion (aOR, 0.36; 95% CI, 0.25-0.53), and of post-operative complications (aOR, 0.79; 95% CI, 0.63-0.99). Tranexamic acid was administered during 128 of 2728 procedures (4.7%); a restrictive transfusion strategy was followed for 96 of the 167 patients who received post-operative blood transfusions (58%). Post-operative anaemia was identified in 1227 of 2069 patients (59.3%) in whom haemoglobin was assessed prior to discharge. The proportion of people re-admitted to hospital within 30 days was larger for patients with anaemia at discharge (169 of 1207 patients followed up, 14.0% v 61 of 825, 7.4%). Haemoglobin assessments were recorded by 30 days after discharge for only 288 patients with post-operative anaemia (24.3%).ConclusionsThe management of peri-operative anaemia differs between hospitals in Australia and New Zealand, with consequences for patient outcomes. Patients are often discharged after surgery with anaemia, which is therefore a potential therapeutic target.Trial RegistrationAustralian New Zealand Clinical Trials Registry, ACTRN12621001517864 (retrospective).© 2022 The Author. Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd.

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