# Prevalence and severity of preoperative anemia, and associated factors among orthopedic patients at public comprehensive referral hospitals, Northwest Ethiopia 2024: multi- center cross-sectional study

## TL;DR

This study found that nearly half of orthopedic patients in Ethiopia had preoperative anemia, which is linked to factors like emergency cases and blood loss.

## Contribution

The study provides new insights into preoperative anemia prevalence and risk factors in orthopedic patients in a conflict-affected region of Ethiopia.

## Key findings

- 46.7% of orthopedic patients had preoperative anemia.
- Emergency cases and blood loss over 500 ml were strongly associated with anemia.
- Patients with coexisting diseases were 1.5 times more likely to have preoperative anemia.

## Abstract

Preoperative anemia is a major clinical problem that increases perioperative patient morbidity and mortality. Additionally, preoperative anemia causes hemodynamic instability, delayed recovery after anaesthesia and surgery, prolong length of hospital stay and increases risk of postoperative infection. However, the prevalence of preoperative anemia remains unexplored in conflict affected areas.

To assess prevalence and severity of preoperative anemia and associated factors among orthopedic patients in Bahir Dar city Comprehensive Referral Hospitals, Northwest Ethiopia, 2024.

Multi-center cross-sectional study was conducted. Data was collected using questionnaire and checklist. All consecutive scheduled emergency and elective patients were included in the study. Data was transformed from Epi data to SPSS and logistic regression analysis was done. Both crude and adjusted odds ratio were used to assess the strength of association. Hosmer –Lemeshow test and multi collinearity were checked. Variables with a p-value of less than 0.05 were considered as statistically significant.

A total of 820 patients were included in this study with a response rate of 99.9%. Prevalence of preoperative anemia was 46.7% (n = 383/820) with (95%, CI = 0.33353- 0.5987) in this study. Emergency orthopedic cases (AOR = 3.014, CI = 2.480–5.717), traumatic related orthopedic cases (AOR = 2.01, CI = 1.480- 3.21), repeated history of anesthesia and orthopedic surgery (AOR = 3.11, CI = 1.480- 3.54), presence of coexisting diseases (AOR = 1.501, CI = 1.002- 3.74) and preoperative blood loss greater than 500 ml (AOR = 3.001, CI = 2.012- 5.104) were associated with preoperative anemia.

The prevalence of preoperative anemia among orthopedic patients was high in the study area. Orthopedic patients should be screened for preoperative anemia routinely. Additionally, nutritional and iron therapy should be given for mild to moderate anemia. Moreover, blood transfusion should be considered for patients with severe anemia.