South African Paediatric Surgical Outcomes Study-2 (SAPSOS-2): a prospective multi-centre pre-post study evaluating haemoglobin response to oral iron for iron-deficiency anaemia in children undergoing elective noncardiac surgery.
Br J AnaesthJul 1, 2026 (epub)
Heidi M Meyer, Alexandra Torborg, Bruce Biccard et al.
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In 30 seconds
The SAPSOS-2 study evaluated the haemoglobin response to oral iron in children with iron-deficiency anaemia undergoing elective noncardiac surgery in South Africa. This prospective multi-centre pre-post study found a median increase in haemoglobin of 1.0 g dl-1 (P=0.001) among those treated, indicating the pathway's feasibility and effectiveness in improving anaemia management.
Key findings
- 23.4% of children screened had Hb below WHO thresholds.
- 40.6% of children with laboratory-confirmed anaemia had iron-deficiency anaemia.
- 65.7% of treated children improved in anaemia severity category.
- 48.6% of treated children were no longer anaemic after treatment.
Why it matters
Preoperative anaemia in children can lead to significant complications. This study demonstrates that a structured management pathway can effectively improve haemoglobin levels, potentially reducing perioperative risks and enhancing surgical outcomes.