title: [Anemia as a surgical risk factor].
abstract: Perioperative anemia is common in patients undergoing surgery and is associated with increased morbidity and mortality and a decreased quality of life. The main causes of anemia in the perioperative context are iron deficiency and chronic inflammation. Anemia can be aggravated by blood loss during surgery, and is most commonly treated with allogeneic transfusion. Moreover, blood transfusions are not without risks, once again increasing patient morbidity and mortality. Given these concerns, we propose to review the pathophysiology of anemia in the surgical environment, as well as its treatment through the consumption of iron-rich foods and by oral or intravenous iron therapy (iron sucrose and iron carboxymaltose). In chronic inflammatory anemia, we use erythropoiesis-stimulating agents (erythropoietin alpha) and, in cases of mixed anemia, the combination of both treatments. The objective is always to reduce the need for perioperative transfusions and speed the recovery from postoperative anemia, as well as decrease the patient morbidity and mortality rate.
authors: Servicio de Anestesiología, Clínica del Dolor, Hospital Universitario de la Santa Creu i Sant Pau, Barcelona, España. Electronic address: vmoralg@santpau.cat.
authors: Victoria
authors: V
authors: Moral García
authors: M
authors: M
authors: Ángeles  Gil de Bernabé Sala
authors: Kinast
authors: K
authors: Nadia Diana
authors: Bartolomé Cantallops
authors: BC
authors: Pericas
authors: Alexia Galindo
authors: AG
authors: Nebot
mesh_terms: D000740:Anemia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D057234:Preoperative Period; D012307:Risk Factors
keywords: Agentes estimulantes eritropoyesis; Anemia perioperatoria; Blood transfusion; Cirugía mayor; Efficacy; Eficacia; Erythropoiesis-stimulating agents; Hierro intravenoso; Intravenous iron; Major surgery; Perioperative anemia; Safety; Seguridad; Trasfusión sanguínea