A NEW study, from Johns Hopkins University School of Medicine, has revealed that treating preoperative iron-deficiency anemia (IDA) with intravenous (IV) iron significantly improves surgical outcomes compared to red blood cell (RBC) transfusion.
The retrospective cohort analysis, spanning 20 years from 2003 to 2023, involved over 154,000 patients from the TriNetX Research Network. Researchers matched patients based on surgery type and health conditions to compare the effects of IV iron and RBC transfusions. The primary outcome was 30-day postoperative mortality with the secondary outcomes being 30-day morbidity, postoperative haemoglobin level, and 30-day postoperative RBC transfusion.
The findings indicated that patients who received preoperative IV iron had a 30% lower risk of postoperative mortality compared to those who underwent RBC transfusions (3.3% vs. 5.2%, CI: 0.60-0.66). Additionally, the IV iron group experienced less postoperative morbidity (18.4% vs. 24.1%) and had higher haemoglobin levels 30 days post-surgery (10.1 g/dL vs. 9.4 g/dL). They also required fewer postoperative blood transfusions.
These results suggest that IV iron not only reduces mortality and morbidity but also enhances postoperative recovery by maintaining higher haemoglobin levels and minimising the need for further transfusions. Given the reduced risks and costs associated with fewer blood transfusions, this study highlights the potential of IV iron as a superior preoperative treatment for IDA.
Helena Bradbury, EMJ
Reference
Choi, Una E et al. A Propensity-Matched Cohort Study of Intravenous Iron versus Red Cell Transfusions for Preoperative Iron-Deficiency Anemia. Anesthesia & Analgesia. 2024
