"QUOTES"

Anemia

"Avoid transfusion regardless of the level of preoperative anemia. Allogeneic blood transfusion should be avoided whenever possible, not only because of associated risks but also because transfusion has not been proven to improve postoperative outcomes."
National Anemia Action Council

"Storage of allogenic blood creates functional degradation in oxygen-carrying red blood cells. (RBCs)."
Accessmylibrary - Shander, Ozawa and Teekam

"Over 3 million people in the United States aged 65 years and older are anemic."
American Society of Hematology

"Anemia should not be accepted as an inevitable consequence of aging."
American Academy of Family Physicians

"The prospect of a doubling in the number of elderly persons over the next 25 years indicates that it is a task that cannot be ignored or deferred."
Jerry L. Spivak, M.D., of The Johns Hopkins University School of Medicine

"Anemia is not normal in the elderly and when identified before surgery requires thorough evaluation."
sbgg.org

"Using World Health Organization criteria for anemia (hemoglobin of less than 12 g per dL [120 g per L] in women and less than 13 g per dL [130 g per L] in men), the prevalence of anemia in the elderly has been found to range from 8 to 44 percent, with the highest prevalence in men 85 years and older."
American Academy of Family Physicians

"Iron-deficiency anemia represents only 15-23% of cases of anemia among the elderly."
emedicine

"Most elderly maintain a normal red blood cell count."
American Academy of Family Physicians

"Chronic kidney disease is an important cause of anemia in elderly persons, especially considering that renal function declines with aging. Reduced renal EPO production is the primary factor leading to anemia in chronic kidney disease.
emedicine

"Vitamin B-12 deficiency is a very uncommon cause of anemia in elderly persons. Folate deficiency is also uncommon, in part related to widespread vitamin supplementation."
American Academy of Family Physicians

"Autoimmune hemolytic anemia (AHIA) is the most common cause in elderly patients."
Health and Age
 
"Undiagnosed pernicious anemia is a common finding in the elderly, especially among black and white women. If these findings can be extrapolated, almost 800,000 elderly people in the United States have undiagnosed and untreated pernicious anemia." Carmel R. Department of Medicine, University of Southern California (USC) School of Medicine, Los Angeles, USA, PubMed

"Anemia is neither normal nor harmless and may have far-reaching effects."
National Anemia Action Council   

"The first step to be taken with the anemic patient is to establish the presence of the problem early enough to do something about it…"
National Anemia Action Council

"One-third to one-half of surgical patients may be anemic preoperatively because of conditions for which they require surgery."
National Anemia Action Council

"Clearly, recombinant erythropoietin should be on everyone’s mind as the first drug of choice to treat anemia in patients who do not need to be transfused."
 Dr. Aryeh Shander, Pulmonary Reviews.com

"Postoperative anemia may occur in up to 90% of patients, probably due to a blunted erythropoietic response."
National Anemia Action Council

"The risks of transfusions can be greater than that of anemia."
Dr. Deitch, Chairman of the Department of Surgery at New Jersey Medical School

"In surgical patients, anemia has been linked to increased postoperative morbidity and mortality,and decreased quality of life."
National Anemia Action Council

"Treatment of perioperative anemia has been shown to decrease the need for transfusion, and improve patient outcomes and quality of life."
National Anemia Action Council

"Treating anemia is the best way to avoid blood transfusions."
Mary Ann Rouch, Blood Conservation Program Coordinator, Presbyterian Hospital of Plano

"The simplest approach is to avoid transfusion regardless of the level of reoperative anemia."
National Anemia Action Council

"Older concepts about oxygen transport to tissues, wound healing, and ‘nutritional value’ of blood are being abandoned. Experience with patients demonstrates that severe anemia is well tolerated."
The Annals of Thoracic Surgery

"Use of erythropoietin alone may eliminate the need for transfusion in some surgical patients, but when transfusion is indicated, the most effective approach may be to combine preoperative erythropoietin administration with procurement of autologous blood by methods such as ANH."
National Anemia Action Council

"Banked blood has little oxygen-delivering ability."
Accessmylibrary - Shander, Ozawa and Teekam

"Autologous predonation can be very effective in reducing reliance on allogeneic blood, but it has been shown to increase overall exposure to [homologous] transfusion and to increase the chance of perioperative anemia."
National Anemia Action Council

"Diagnostic testing is an important cause of blood loss in critically ill patients. Blood samples for diagnostic testing are commonly taken up to 24 times per day depending on patient illness acuity, ease of sampling and institutional practice. The reduction of blood loss associated with diagnostic testing seems a logical, proximate intervention and may reduce the burden of anemia among critically ill patients."
Alan Tinmouth et al, Canadian Medical Association Journal

"Blood transfusion has not been shown to reduce morbidity and mortality in surgical patients, but alternatives such as erythropoietin have."
National Anemia Action Council