Return on Investment of Preoperative Anemia Management Programs in Cardiac Surgery: An Advisory From the Society of Cardiovascular Anesthesiologists Clinical Practice Improvement Committee With Endorsement by the Society for the Advancement of Patient Blood Management

Matthew A Warner; Renata Ferreira; Jacob Raphael; Linda Shore-Lesserson; Michael C Grant; Shanna Sykes Hill; Gordon Morewood; Wanda M Popescu; Nanette Schwann; Nicole R Guinn

doi:10.1213/ANE.0000000000006721

Return on Investment of Preoperative Anemia Management Programs in Cardiac Surgery: An Advisory From the Society of Cardiovascular Anesthesiologists Clinical Practice Improvement Committee With Endorsement by the Society for the Advancement of Patient Blood Management

Anesth Analg. 2024 Nov 7. doi: 10.1213/ANE.0000000000006721. Online ahead of print.

Authors

Affiliations

¹ From the Department of Anesthesiology & Perioperative Medicine, Mayo Clinic, Rochester, Minnesota.
² Department of Anesthesiology, Missoula Anesthesiology and International Heart Institute, Missoula, Montana.
³ Department of Anesthesiology and Perioperative Medicine, Thomas Jefferson University Hospital, Sidney Kimmel Medical College, Philadelphia, Pennsylvania.
⁴ Department of Anesthesiology, Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York.
⁵ Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
⁶ Department of Anesthesiology, Weill Cornell Medicine, New York, New York.
⁷ Department of Anesthesiology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.
⁸ Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut.
⁹ Department of Anesthesiology, Lehigh Valley Health Network, Allentown, Pennsylvania.
¹⁰ Division of Surgical Anesthesiology, Department of Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida; and.
¹¹ Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina.

PMID: 39671509
DOI: 10.1213/ANE.0000000000006721

Abstract

Despite multiple recent guidelines recommending the diagnosis and treatment of anemia before elective cardiac surgery, few institutions have formal programs or methods in place to accomplish this. A major limitation is the perceived financial shortfall and the leadership buy-in required to undertake such an initiative. The purpose of this advisory from the Society of Cardiovascular Anesthesiologists (SCA) Clinical Practice Improvement Committee with endorsement by the Society for the Advancement of Patient Blood Management (SABM) is to provide an overview of preoperative anemia management programs with an emphasis on the associated financial implications. This advisory reviews the evidence for preoperative anemia management programs in both cardiac and noncardiac surgery, discusses options for managing preoperative anemia, provides novel financial modeling regarding the implementation of preoperative anemia management programs, and describes implementation challenges, potential solutions, and opportunities for improvement.