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PLASTIC RECONSTRUCTIVE AND REGENERATIVE SURGERY

Abstract

Chronic iron deficiency anaemia (IDA) is frequently encountered in the emergency department (ED), particularly among elderly and frail patients with multiple comorbidities. Despite recommendations discouraging red blood cell (RBC) transfusion in haemodynamically stable patients without active bleeding, transfusions are not uncommon in ED practice. Patient Blood Management (PBM) strategies aim to optimize anaemia treatment, potentially reducing unnecessary transfusions and improving outcomes, but their impact is still poorly studied in the ED setting.
We conducted a retrospective observational study enrolling adult patients presenting to the ED of a tertiary University Hospital between 2021 and 2023 for or with at least moderate chronic IDA. Thirty-six patients referred to a structured PBM pathway with early post-discharge intravenous iron therapy were compared with 28 matched controls discharged without specialist referral. We found that a PBM approach in the ED was significantly associated with fewer patients transfused (11/36 vs 21/28, p < 0.001) and, more remarkably, with fewer anaemia-related ED readmissions or hospitalizations in the following 6 months (3/36 vs 8/28, p = 0.033). This study reinforces the need for implementing a PBM strategy as early as in the ED. 

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Authors

Giacomo Marchi - Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata, Verona, Italy https://orcid.org/0000-0002-4628-4825

Fabio Chesini - Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata, Verona, Italy https://orcid.org/0009-0001-5770-8160

Alice Vianello - Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata, Verona, Italy https://orcid.org/0000-0002-2428-4760

Ciro Paolillo - Emergency Department, Azienda Ospedaliera Universitaria Integrata, Verona , Italy

Antonio Maccagnani - Emergency Department, Azienda Ospedaliera Universitaria Integrata, Verona , Italy

Domenico Girelli - Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata, Verona, Italy https://orcid.org/0000-0001-9684-1899

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