ArticleWorld journal of surgery2026
Management of PErioperative Anemia in EmeRgency Laparotomy Patients (PEARL Study).
Article in World journal of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND/
aimThere has been a drive on improving outcomes after Emergency Laparotomy (EmLap) due to the National Emergency Laparotomy Audit (NELA). This has focused mainly on preoperative and intraoperative management with less emphasis on other perioperative aspects. We aimed to assess the prevalence of anemia in EmLap patients and its management in a perioperative period, exploring the gaps in anemia care.
methodsA retrospective cohort study of prospectively maintained database of 1055 EmLap patients (2016-2019) from a UK tertiary center was performed. Data were extracted from the NELA database, POLO study, electronic records (Welsh Clinical Portal). Statistics were performed in SPSS v27.
resultsAmong 740 patients, 77% underwent open surgery, with mean age of 61.9 years (range 18-98), median age of 65 years, and roughly equal sex distribution (female 54%). The median preoperative NELA risk was 3.6% (IQR 1.1-9.8). Over a quarter of patients (28.6%) were anemic on admission. Anemic patients had significantly longer hospital stays (median 12 days; >/ = 11 days, p = 0.008) and higher stoma formation rates (54.1% moderate anemia vs. 34.3% nonanemic; p = 0.002). Three-quarters of patients (74.2%) were anemic at discharge (median Hb: 108 g/L, range: 74-129 g/L) but only 12% were treated with oral or IV iron or blood transfusion; only 10% had anemia reported in their discharge letters with appropriate follow-up and management plan.
conclusionsAnemia in patients undergoing emergency laparotomy is significantly under-recognized and inadequately managed at discharge, despite recognized increased morbidity. A structured pathway for continuing anemia treatment and discharge planning is urgently needed to improve outcomes.
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