Fit For Surgery: Managing Iron Deficiency Anaemia

Resources for general practitioners managing patients undergoing planned surgery

NPS MedicineWise and the National Blood Authority have collaborated to develop a suite of resources to assist you in helping your patients get fit for surgery.

The National Blood Authority (NBA) is funding and managing the development of evidence-based modules, Patient Blood Management (PBM) Guidelines. The PBM Guidelines reflect a systematic review of the scientific literature considered by a Clinical/Consumer Reference Group represented by experts from relevant colleges, societies and consumer groups.

Patient blood management principles are based on the idea that the patients own blood is optimised before, during and after surgery to improve clinical outcomes by avoiding unnecessary exposure to donated blood products.4

Around one in five patients undergoing elective surgery will have anaemia,1-3 perioperative anaemia is itself associated with poorer outcomes such as slower recovery.2,3 Anaemia is also associated with an increased likelihood of red blood cell transfusion.2,3,4 Blood transfusion is associated with increased risk of mortality, morbidity, ICU length of stay and hospital length of stay.2,3, 4

Health News and Evidence article

Health Topics- Fit for surgery

Elective surgery patient blood management decision aid

How you help your patients prepare for their surgery will depend on whether they are iron replete, iron deficient or anaemic. This decision aid is designed to help simplify the decision process.

These decision aids should be used when making management decisions for:

People preparing for planned surgery where blood loss is anticipated

Assess for iron deficiency and anaemia

  • Full blood count
  • Iron studies including serum Ferritin
  • C-reactive protein and renal function

Does the patient have a history of chronic illness or inflammation, or evidence of inflammation through elevation of inflammatory markers?

Yes                                 No  

Elective surgery example referral letter

Communication is important to ensure you, your patient and the care team at the hospital are fully informed. This example referral letter contains information that you may want to include in your correspondence with specialists and hospitals.

Fit for Surgery Sample referral letter (pdf) (216.3 KB)

Patient support materials

NPS MedicineWise and the National Blood Authority have developed a set of patient support materials to help you disseminate important information to your patients who are planning surgery.

Fit for surgery, fit for life is an infographic tool and personalised iron plan that sets out the need for optimal iron management in the lead up to surgery. It contains a personal record that patients may want to keep with them to ensure their care team are always fully informed about their iron status.

Managing my iron is a fact sheet outlining the treatments that are available to manage iron. This may be particularly helpful for patients who have been identified as having an iron deficiency.

Fit for surgery is a fact sheet outlining for your patient the steps that need to be taken to get them fit for surgery. It details the need for investigations and changes in medicine regimens.

My guide to blood transfusions is a fact sheet that explores why patients may need a transfusion, the risks associated with transfusion and what actions they can take to help them avoid needing one.

  1. R. Sinha, K. Robinson, R. Allden, et al. Gap analysis of pre-operative anaemia rates in surgical patients in SA hospitals. 2015.  (accessed 13 August 2015).
  2. L. T. Goodnough, A. Maniatis, P. Earnshaw, et al. Detection, evaluation, and management of preoperative anaemia in the elective orthopaedic surgical patient: NATA guidelines. Br J Anaesth 2011;106:13-22.
  3. S. Minck, K. Robinson, B. Saxon, et al. Patient blood management -- the GP's guide. Aust Fam Physician 2013;42:291-7.
  4. National Blood Authority. Patient blood management guidelines: Module 2 Perioperative. 2012. (accessed 13 August 2015).