BACKGROUND: The aim of this study was to investigate the association between perioperative anaemia and blood transfusions with postoperative length of stay in emergency and elective hemicolectomies.

METHOD: We performed a retrospective study looking at pre- and postoperative haemoglobin (Hb) levels for all patients undergoing elective or emergency hemicolectomies between 01/07/15 and 30/06/16 at The Lister Hospital, Stevenage. Our primary outcome was length of postoperative stay in hospital. We also looked at the impact of intraoperative and postoperative blood transfusions.

RESULTS: 59% of patients (n=85) were anaemic preoperatively and this rose to 85% postoperatively. The mean Hb change was -11.59 g/dL. 70 patients (n= 85) had a drop in Hb postoperatively (mean Hb drop = 15.2 g/dL, SD 10.33). The mean length of stay post-procedure was 13.40 days (SD 14.11). Length of stay was longest for preoperatively anaemic patients (mean 14.27 days, SD 15.08), followed by postoperatively anaemic patients (mean 13.32 days, SD 13.94). Mean length of stay was 12.1 days (SD 13.98) for elective patients and 16.91 days (SD 14.14) for emergency patients. 61% of elective patients were preoperatively anaemic vs 50% of emergency patients. 28% of patients (n=24) received blood transfusions in the intraoperative or postoperative period. A total of 48 units of packed red blood cells, 4 units of fresh frozen plasma and 1 unit of platelets were used. The mean length of stay was 24.0 days (SD 20.41) for patients who received blood transfusions and 10.94 days (SD 11.44) for patients who did not receive blood transfusions.

CONCLUSIONS: A large number of patients were preoperatively anaemic and the incidence of anaemia was higher postoperatively. Postoperative length of stay in hospital was longest for patients who received blood transfusions in the intraoperative or postoperative period. A higher length of stay was also associated with preoperative anaemia and with emergency surgery. A higher percentage of elective patients were preoperatively anaemic when compared with emergency patients. There is scope for further preoptimisation of anaemia in elective hemicolectomy patients. This may result in a shorter length of postoperative stay, improving patient outcomes and reducing hospital costs.

The impact of perioperative anaemia on length of hospital stay in patients undergoing hemicolectomy surgery