Abstract:
Background: Preoperative anemia, affecting about 35% of surgical patients, is a major risk factor
for increased morbidity and mortality. It elevates the need for blood transfusion, which prolongs
hospital stay and raises risks of infection, intensive care unit admission, cardiac events, stroke, and
renal complications. Despite the seriousness of the problem there is information gap regarding the
magnitude of preoperative anemia and its associated factors in the study area.
OBJECTIVE: To assess magnitude and associated factors of preoperative anemia among adult
elective surgical patients at public hospitals of harar, Eastern Ethiopia, from July 1 to August 31,
2025.
Methods: Institution-based cross-sectional study was conducted among 394 adult elective surgical
patients selected using a systematic random sampling technique. Data were collected from patient
charts using a structured checklist, entered into EpiData version 4.6, and analyzed with STATA
version 17. Descriptive statistics summarized patient characteristics. Factors with a p-value ≤0.2
in the bivariable models were candidates for the multivariable model. Adjusted odds ratios
alongside 95% confidence intervals were estimated to measure the strength of association between
variables of interest and level of statistical significance was declared at p-value < 0.05.
Result: Among 394 participants, mean age was 44 ± 14.7 years, and 56.9% were female. The
mean hemoglobin level was 12.69 ± 1.9 g/dl. The overall prevalence of preoperative anemia was
38.6% (95% CI: 33.9 - 43.5). Female patients were less likely to be anemic than males (AOR =
0.46, 95% CI: 0.28 - 0.76). A unit increase in body mass index reduced preoperative anemia odds
by 13% (AOR = 0.87, 95% CI: 0.79 - 0.96). Compared to general surgery, orthopedic and
plastic/reconstructive surgeries had higher odds (AOR = 2.62, 95% CI: 1.46 - 4.69). History of
blood loss was also significant (AOR = 2.41, 95% CI: 1.12 - 5.18).
Conclusion: Preoperative anemia affected nearly two out of five adult elective surgical patients in
Harar. Factors such as low body mass index , orthopedic or reconstructive surgery, and a history
of blood loss and male gender were linked to preoperative anemia. Therefore, it is crucial to
Strengthen preoperative evaluation, nutritional support, and bleeding control measures to reduce
the burden of anemia and improve surgical outcomes.
