Cargando…

Preoperative Anemia Treatment With Intravenous Iron in Patients Undergoing Major Orthopedic Surgery: A Systematic Review

INTRODUCTION: Based upon the Third National Health and Nutrition Examination Survey data, iron deficiency anemia is the cause of at least 20% of cases of anemia in adults over the age of 65. This is especially relevant in patients undergoing major orthopedic surgery as substantial perioperative bloo...

Descripción completa

Detalles Bibliográficos
Autores principales: Smith, Aaron, Moon, Tiffany, Pak, Taylor, Park, Brian, Urman, Richard D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7323265/
https://www.ncbi.nlm.nih.gov/pubmed/32637197
http://dx.doi.org/10.1177/2151459320935094
_version_ 1783551758781382656
author Smith, Aaron
Moon, Tiffany
Pak, Taylor
Park, Brian
Urman, Richard D.
author_facet Smith, Aaron
Moon, Tiffany
Pak, Taylor
Park, Brian
Urman, Richard D.
author_sort Smith, Aaron
collection PubMed
description INTRODUCTION: Based upon the Third National Health and Nutrition Examination Survey data, iron deficiency anemia is the cause of at least 20% of cases of anemia in adults over the age of 65. This is especially relevant in patients undergoing major orthopedic surgery as substantial perioperative blood loss is possible, leading to a high rate of allogeneic blood transfusion in total hip replacements, total knee replacements, and hip fracture repairs. SIGNIFICANCE: The results of this systematic review may be of interest to clinicians and hospital administrators evaluating the clinical efficacy and cost effectiveness of intravenous (IV) iron administration prior to major orthopedic surgery. MATERIALS AND METHODS: The original studies considered for this review included patients who were over 18 years of age, undergoing major orthopedic surgery, and who received an IV iron treatment in the preoperative setting. A total of 1083 articles were identified and reviewed. After removing duplicates, 1031 publications were screened, and 105 full-text studies were assessed for eligibility. A total of 98 were excluded and 7 articles remained which met the criteria for this review. The primary outcome examined in the included studies was the allogeneic blood transfusion rate. The secondary areas of interest were changes in serum hemoglobin, morbidity and mortality, length of stay, and cost effectiveness. RESULTS: This systematic review found little evidence that IV iron therapy is effective at reducing transfusion in patients undergoing major orthopedic surgery. CONCLUSIONS: We do not recommend preoperative IV iron therapy for all patients scheduled for major orthopedic surgery.
format Online
Article
Text
id pubmed-7323265
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-73232652020-07-06 Preoperative Anemia Treatment With Intravenous Iron in Patients Undergoing Major Orthopedic Surgery: A Systematic Review Smith, Aaron Moon, Tiffany Pak, Taylor Park, Brian Urman, Richard D. Geriatr Orthop Surg Rehabil Medical Student Corner INTRODUCTION: Based upon the Third National Health and Nutrition Examination Survey data, iron deficiency anemia is the cause of at least 20% of cases of anemia in adults over the age of 65. This is especially relevant in patients undergoing major orthopedic surgery as substantial perioperative blood loss is possible, leading to a high rate of allogeneic blood transfusion in total hip replacements, total knee replacements, and hip fracture repairs. SIGNIFICANCE: The results of this systematic review may be of interest to clinicians and hospital administrators evaluating the clinical efficacy and cost effectiveness of intravenous (IV) iron administration prior to major orthopedic surgery. MATERIALS AND METHODS: The original studies considered for this review included patients who were over 18 years of age, undergoing major orthopedic surgery, and who received an IV iron treatment in the preoperative setting. A total of 1083 articles were identified and reviewed. After removing duplicates, 1031 publications were screened, and 105 full-text studies were assessed for eligibility. A total of 98 were excluded and 7 articles remained which met the criteria for this review. The primary outcome examined in the included studies was the allogeneic blood transfusion rate. The secondary areas of interest were changes in serum hemoglobin, morbidity and mortality, length of stay, and cost effectiveness. RESULTS: This systematic review found little evidence that IV iron therapy is effective at reducing transfusion in patients undergoing major orthopedic surgery. CONCLUSIONS: We do not recommend preoperative IV iron therapy for all patients scheduled for major orthopedic surgery. SAGE Publications 2020-06-26 /pmc/articles/PMC7323265/ /pubmed/32637197 http://dx.doi.org/10.1177/2151459320935094 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Medical Student Corner
Smith, Aaron
Moon, Tiffany
Pak, Taylor
Park, Brian
Urman, Richard D.
Preoperative Anemia Treatment With Intravenous Iron in Patients Undergoing Major Orthopedic Surgery: A Systematic Review
title Preoperative Anemia Treatment With Intravenous Iron in Patients Undergoing Major Orthopedic Surgery: A Systematic Review
title_full Preoperative Anemia Treatment With Intravenous Iron in Patients Undergoing Major Orthopedic Surgery: A Systematic Review
title_fullStr Preoperative Anemia Treatment With Intravenous Iron in Patients Undergoing Major Orthopedic Surgery: A Systematic Review
title_full_unstemmed Preoperative Anemia Treatment With Intravenous Iron in Patients Undergoing Major Orthopedic Surgery: A Systematic Review
title_short Preoperative Anemia Treatment With Intravenous Iron in Patients Undergoing Major Orthopedic Surgery: A Systematic Review
title_sort preoperative anemia treatment with intravenous iron in patients undergoing major orthopedic surgery: a systematic review
topic Medical Student Corner
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7323265/
https://www.ncbi.nlm.nih.gov/pubmed/32637197
http://dx.doi.org/10.1177/2151459320935094
work_keys_str_mv AT smithaaron preoperativeanemiatreatmentwithintravenousironinpatientsundergoingmajororthopedicsurgeryasystematicreview
AT moontiffany preoperativeanemiatreatmentwithintravenousironinpatientsundergoingmajororthopedicsurgeryasystematicreview
AT paktaylor preoperativeanemiatreatmentwithintravenousironinpatientsundergoingmajororthopedicsurgeryasystematicreview
AT parkbrian preoperativeanemiatreatmentwithintravenousironinpatientsundergoingmajororthopedicsurgeryasystematicreview
AT urmanrichardd preoperativeanemiatreatmentwithintravenousironinpatientsundergoingmajororthopedicsurgeryasystematicreview