Background and Goal of Study: Patient optimization prior to surgery is one of the keys of success in order to improve the postoperative outcomes. Pre-anesthetic evaluation can enhance preoperative physical status of surgical patients.(1) Yet, what are we actually doing in every-day practice? Can we find any factor to improve safety and quality? The aim of this audit is to report the anaemia prevalence and to analyze the length of the preoperative fasting period in a population scheduled for surgery and to assess the follow up of the current guidelines in a university tertiary referral hospital (UTRH).

Material and methods: During one week of clinical practice we audited all the patients scheduled for surgery in a UTRH (including obstetrics and excluding anaesthesia outside OR, emergencies, day case, ophthalmology, cardiothoracic and pediatric surgery). We retrospectively reviewed records from all patients (hemoglobin levels, time frame since the last blood test, most relevant metabolic disorders, type of surgery and previous fasting period).

Results and Discussion: We recorded a total of 254 patients. Anaemia prevalence was 14.9%(n=37), and 62.7%(n=23) of these patients were programmed for major surgery. 57%(n=21) of anaemic patients were women. Anaemia prevalence in orthopedic surgery patients was 25%(n=8) (higher than the mean prevalence). The blood tests to assess anaemia had been performed <1 month before surgery in 81.1%(n=30), 1-3 months in 13.5%(n=5) and >3 months in 5.4%(n=2). (2) Patients fasting period before major surgery was: between 6-10 h in 31.8%(n=40), 10-14 h in 50.8%(n=64) and >14 h in 17.5%(n=22). Among diabetic patients, the fasting period was between 10-14 h in 64%(n=12) and >14 h in 16%(n=2). (3)

Conclusion: 
Anaemia prevalence is high in our cohort, especially in women and patients of orthopedic surgery. Fasting recommendations are exceeded in a large percentage of cases, even for diabetic patients. Major surgery, first step of patient blood management and accuracy or synchrony of surgical lists and fasting periods should be encouraged and implemented in our hospitals.

References:
1. Quecedo L. et al. Rev Esp Anestesiol Reanim.2016;63:519-27.
2. Shander A. et al. Anesthesiol Clin.2016;34:711–30.
3. López AC. et al. Rev Esp Anestesiol Reanim.2015;62:145-56.


10 / Perioperative anaemia and fasting period, an audit of clinical practice. Easy to do it better?