4.7 Article

The impact of intravenous iron supplementation in elderly patients undergoing major surgery

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BMC GERIATRICS
卷 22, 期 1, 页码 -

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BMC
DOI: 10.1186/s12877-022-02983-y

关键词

Iron deficiency; Elderly; Geriatric patients; Surgery; Patient care; Intravenous iron

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  1. Projekt DEAL

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This study found that intravenous iron supplementation can increase hemoglobin levels in elderly surgical patients with anemia, reducing the need for blood transfusions. Severely anemic patients who received iron supplementation 6-10 days and > 10 days before surgery showed an increase in hemoglobin levels of 0.6 and 1.2 g/dl respectively. Overall, 58% of anemic iron-deficient patients experienced an increase in hemoglobin of > 0.5 g/dl.
Background Age and preoperative anaemia are risk factors for poor surgical outcome and blood transfusion. The aim of this study was to examine the effect of iron supplementation in iron-deficient (ID) elderly patients undergoing major surgery. Method In this single-centre observational study, patients >= 65 years undergoing major surgery were screened for anaemia and ID. Patients were assigned to the following groups: A(-) (no anaemia); A(-),ID+,T+ (no anaemia, iron-deficient, intravenous iron supplementation); A(+) (anaemia); and A(+),ID+,T+ (anaemia, iron-deficient, intravenous iron supplementation). Results Of 4,381 patients screened at the anaemia walk-in clinic, 2,381 (54%) patients were >= 65 years old and 2,191 cases were included in analysis. The ID prevalence was 63% in patients with haemoglobin (Hb) < 8 g/dl, 47.2% in patients with Hb from 8.0 to 8.9 g/dl, and 44.3% in patients with Hb from 9 to 9.9 g/dl. In severely anaemic patients, an Hb increase of 0.6 (0.4; 1.2) and 1.2 (0.7; 1.6) g/dl was detected with iron supplementation 6-10 and > 10 days before surgery, respectively. Hb increased by 0 (-0.1; 0) g/dl with iron supplementation 1-5 days before surgery, 0.2 (-0.1; 0.5) g/dl with iron supplementation 6-10 days before surgery, and 0.2 (-0.2; 1.1) g/dl with supplementation > 10 days before surgery (p < 0.001 for 1-5 vs. 6-10 days). Overall, 58% of A(+),ID+,T+ patients showed an Hb increase of > 0.5 g/dl. The number of transfused red blood cell units was significantly lower in patients supplemented with iron (0 (0; 3)) compared to non-treated anaemic patients (1 (0; 4)) (p = 0.03). Patients with iron supplementation > 6 days before surgery achieved mobility 2 days earlier than patients with iron supplementation < 6 days. Conclusions Intravenous iron supplementation increases Hb level and thereby reduces blood transfusion rate in elderly surgical patients with ID anaemia.

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