Abdul Mannan: Surgical Outcomes Study Re-evaluates Preoperative Anaemia Risk in Women
Abdul Mannan, Consultant Haematologist at Betsi Cadwaladr University Health Board, shared a post on LinkedIn about a recent article by Florian Rumpf et al., published in Frontiers Medicine, adding:
”For years we’ve been told women tolerate low haemoglobin better than men. A study of 842,130 surgical patients just put that idea to the test. It didn’t survive.
Anaemia thresholds have always been set from the low end of the normal range in healthy people, not from what actually happens to patients. The German Patient Blood Management Network set out to find a threshold based on outcomes instead.
Here’s what the data showed:
- Every 1 g/dL drop in preoperative haemoglobin raised the odds of in-hospital death by roughly 20 percent
- A threshold of 10.5 g/dL carried equal mortality risk for men and women
- Below 10.5 g/dL, that risk rose faster for women, not men
- Women received fewer transfusions than men at the same haemoglobin level, so that alone doesn’t explain the gap
Rumpf et al., Frontiers in Medicine, 2024, based on data from 14 German hospitals over a decade.
The authors are clear this shouldn’t change protocols yet. But it’s a strong nudge to stop assuming women can safely run lower.
Should preoperative haemoglobin targets differ by sex in your unit?”
Title: Preoperative hemoglobin thresholds for survival equity in women and men
Authors: Florian Rumpf, Lotta Hof, Oliver Old, Patrick Friederich, Jens Friedrich, Josef Thoma, Maria Wittmann, Kai Zacharowski, Suma Choorapoikayil, Patrick Meybohm
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