[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-443943-105":3,"detail-sidebar-cat-0-en-105":80,"doc-detail-443943-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","postoperative-anaemia-the-unseen-challenge-in-cardiac-surgery-editorial","Postoperative anaemia: the unseen challenge in cardiac surgery - Editorial","","Postoperative anaemia is an overlooked complication of cardiac surgery linked to adverse clinical outcomes. Small trials suggest that intravenous iron can improve haemoglobin recovery and reduce transfusion use, but definitive, appropriately powered randomised trials are needed to establish effects on patient- and clinician-important outcomes. Perioperative anaemia management requires renewed attention to prevention and treatment. The article also discusses evidence for preoperative treatment, guideline endorsement, and the clinical relevance of postoperative anaemia after cardiac surgery.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/postoperative-anaemia-the-unseen-challenge-in-cardiac-surgery-editorial/443943/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/postoperative-anaemia-the-unseen-challenge-in-cardiac-surgery-editorial/443943.png","ImageObject",300,407,{"name":42,"@type":43},"Angel","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-04","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":30},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"Why is postoperative anaemia considered a major issue in cardiac surgery?","Question",{"text":62,"@type":63},"Postoperative anaemia is described as an overlooked complication associated with adverse clinical outcomes after cardiac surgery.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"What does existing evidence suggest about treating postoperative anaemia with iron?",{"text":67,"@type":63},"Small clinical trials indicate that intravenous iron can improve haemoglobin recovery and reduce transfusion utilisation, although larger trials are needed to confirm impacts on important clinical outcomes.",{"name":69,"@type":60,"acceptedAnswer":70},"What is required to definitively evaluate treatment efficacy?",{"text":71,"@type":63},"Appropriately powered randomised controlled trials are necessary to evaluate whether treatment improves clinical outcomes that matter to patients, clinicians, and healthcare systems.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},443943,1791031208,{"code":4,"msg":81,"data":82},"success",[83,87,91,95,100,105,109,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":84,"show_sort_weight":85,"slug":86},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":88,"show_sort_weight":89,"slug":90},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":92,"show_sort_weight":93,"slug":94},"Exam",70,"exam",{"id":96,"doc_module":4,"doc_module_name":25,"category_name":97,"show_sort_weight":98,"slug":99},5,"Comic",60,"comic",{"id":101,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},6,"Technology",50,"technology",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":107,"slug":108},7,40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":96,"slug":129},19,"General","general",{"code":4,"msg":81,"data":131},{"doc_id":78,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":106,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":30,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":30,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":110},687207412472,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Open  \nBJA Open, 17 (C): 100514 (2026)  \ndoi: 10.1016/j.bjao.2025.100514  \nEditorial  \n\n| \u003Cbr>|  |  |\n| --- | --- | --- |\n| Postoperative anaemia: the unseen challenge in cardiac surgery\u003Cbr>Matthew A. Warner1,* and Jacob Raphael2\u003Cbr>1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA and 2Department of Anesthesiology, Thomas Jefferson University, Philadelphia, PA, USA\u003Cbr>*Corresponding [author. E-mail:](author. E-mail: warner.matthew@mayo.edu)[ warner.matthew@mayo.edu](author. E-mail: warner.matthew@mayo.edu) |  | |\n| Summary\u003Cbr>Postoperative anaemia is an overlooked complication of cardiac surgery that is associated with adverse clinical outcomes. Although small clinical trials suggest that postoperative treatment with i.v. iron improves haemoglobin recovery and reduces transfusion utilisation, appropriately powered randomised controlled trials are necessary to definitively evaluate the efficacy of treatment on clinical outcomes of importance to patients, clinicians, and healthcare systems. A comprehensive approach to perioperative anaemia management demands a renewed focus on both prevention and treatment to improve patient outcomes.\u003Cbr>Keywords: anaemia; cardiac surgery; haemoglobin; iron deficiency; patient-centred outcomes; patient blood management; postoperative; transfusion |  |  |\n| Preoperative anaemia is a modifiable risk factor for adverse | injury, and deep sternal wound infection. After analysing a |  |\n| cardiac surgical outcomes.1—4 Clinical trials demonstrate that | cohort of 5960 patients, they report that each 10 g L—1 decrease |  |\n| treatment of anaemia in advance of surgery improves haemoglobin recovery and reduces allogeneic transfusions,5—7 | in haemoglobin was associated with a 1.15 (95% confidence\u003Cbr>interval [CI] 1.05—1.25) increase in the odds of the primary |  |\n| with a large forthcoming trial evaluating the impact on | outcome after adjustment for key covariates, including pre- |  |\n| patient-centred outcomes.8 Preoperative anaemia treatment | operative haemoglobin, perioperative transfusions, and sur- |  |\n| has been endorsed in multiple clinical practice guidelines.9—12 | gical features. Further, a nadir haemoglobin \u003C80 g L—1 was |  |\n| Yet, only a small percentage of patients with anaemia before | associated with a 1.44 (95% CI 1.19—1.75) increase in the odds |  |\n| cardiac surgery receives dedicated anaemia evaluations, and | of the primary composite outcome. |  |\n| an even smaller proportion receives anaemia-directed | By using continuous haemoglobin concentrations as their |  |\n| therapies.13,14 Hence, although many consider treatment of | primary exposure rather than arbitrary bins of anaemia |  |\n| preoperative anaemia a standard of care,15 the reality is that | severity, the authors were able to identify an inflection point |  |\n| implementation remains sparse. | for increasing risk as the haemoglobin concentration de- |  |\n| In this issue, Alkadri and colleagues16 focus on a related but | creases below 10—11 g dl—1. This is consistent with data from |  |\n| distinct clinical entity―postoperative anaemia occurring after | several other surgical populations,17—19 providing a potential |  |\n| cardiac surgery. Despite the near ubiquity of anaemia after | target at which treatment should be evaluated in clinical trials. |  |\n| cardiac surgery, few studies have evaluated its association | There were no significant interactions by patient sex, high- |  |\n| with clinical outcomes. Specifically, the authors evaluated the | lighting that postoperative anaemia is similarly accompanied |  |\n| association between the nadir haemoglobin concentration on | by adverse clinical outcomes in both women and men. |  |\n| postoperative day 1 and a primary composite outcome of 30- | Strengths of the study include predefined exposures and out- |  |\n| day mortality, stroke, myocardial infarction, acute kidney | comes with mechanistic plausibility, careful adjustment for |  |\n| ","cbCaidG85QnkZk5P","https://ap.wps.com/l/cbCaidG85QnkZk5P","pdf",247902,"English","# Summary\n## Rationale for perioperative anaemia management\n## Evidence for anaemia treatment and timing\n## Postoperative anaemia and clinical outcomes\n## Ongoing trial needs and study implications","[{\"question\":\"Why is postoperative anaemia considered a major issue in cardiac surgery?\",\"answer\":\"Postoperative anaemia is described as an overlooked complication associated with adverse clinical outcomes after cardiac surgery.\"},{\"question\":\"What does existing evidence suggest about treating postoperative anaemia with iron?\",\"answer\":\"Small clinical trials indicate that intravenous iron can improve haemoglobin recovery and reduce transfusion utilisation, although larger trials are needed to confirm impacts on important clinical outcomes.\"},{\"question\":\"What is required to definitively evaluate treatment efficacy?\",\"answer\":\"Appropriately powered randomised controlled trials are necessary to evaluate whether treatment improves clinical outcomes that matter to patients, clinicians, and healthcare systems.\"}]","Postoperative anaemia: the unseen challenge in cardiac surgery - Editorial | PDF",1790706163]