MAGNITUDE AND ASSOCIATED FACTORS OF PREOPERATIVE ANEMIA AMONG ADULT ELECTIVE SURGICAL PATIENTS AT PUBLIC HOSPITALS OF HARAR, EASTERN ETHIOPIA.

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.