Dealing with risk factors before surgery

High risk clinic

If your surgeon, doctor or cardiopulmonary exercise test suggest that you are at high risk of complications from your surgery, we may invite you to attend an additional clinic with a peri-operative medicine consultant.  

The aim of this clinic is to carefully evaluate your health, chronic medical conditions and lifestyle to see if these can be optimised in any way.  

We will ask you to complete a number of questionnaires before the consultation starts. During the appointment we will explore what you hope to gain from surgery and the outcomes that are most important to you.  

We will discuss the risks and benefits of surgery in your particular case and help you to make an informed choice regarding whether surgery is the right option for you. Should you decide to proceed with surgery, we will agree a plan with you to ensure that you are in the best condition for your operation.  

This will include optimising any chronic health conditions (such as diabetes control or anaemia), improving your nutritional state and increasing your physical fitness. All of these interventions will help to prepare you for surgery, minimise your risk of complications and improve your chance of making a swift recovery back to your normal lifestyle.

Perioperative anaemia service

Around 30% of patients are found to be anaemic prior to surgery. This is often caused by the body not having enough iron stores or losing too much iron to make new red cells in your bone marrow.

Being anaemic increases your risk of surgery and you are more likely to need blood transfusion. We also know that if you are anaemic is can result in a slower recovery.

If you are showing signs of anaemia on your preoperative bloods your surgeon or your anaesthetist will refer you to our perioperative anaemia service. Correcting anaemia before your surgery may reduce your complications after surgery and will decrease your chance of needing blood transfusion.

In most cases we can treat anaemia with iron either in tablet form or by an intravenous infusion prior to surgery.

We will contact you if we feel you would benefit from having iron and arrange the treatment with you. If we advise the intravenous option, it takes around one to two hours to administer. It is a very safe and effective treatment.

It can take up to three weeks after an iron infusion for it to improve your anaemia, in some cases you may require more than one infusion.

If you are having surgery on your bowel, liver, kidney, pancreas, bladder, oesophagus, throat or face and have any questions, or are concerned that you may be anaemic, please contact the perioperative anaemia nurse on 023 8120 8911.