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The impact of iron store on red blood cell transfusion: a multicentre prospective cohort study in cardiac surgery
BACKGROUND: Anaemia is common prior to cardiac surgery and contributes to perioperative morbidity. Iron deficiency is the main cause of anaemia but its impact remains controversial in the surgical setting. We aimed to estimate the impact of iron deficiency on in-hospital perioperative red blood cell...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8935744/ https://www.ncbi.nlm.nih.gov/pubmed/35313823 http://dx.doi.org/10.1186/s12871-022-01616-6 |
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author | Gaudriot, Baptiste Oilleau, Jean-Ferreol Kerforne, Thomas Ecoffey, Claude Huet, Olivier Mansour, Alexandre Verhoye, Jean-Philippe Massart, Nicolas Nesseler, Nicolas |
author_facet | Gaudriot, Baptiste Oilleau, Jean-Ferreol Kerforne, Thomas Ecoffey, Claude Huet, Olivier Mansour, Alexandre Verhoye, Jean-Philippe Massart, Nicolas Nesseler, Nicolas |
author_sort | Gaudriot, Baptiste |
collection | PubMed |
description | BACKGROUND: Anaemia is common prior to cardiac surgery and contributes to perioperative morbidity. Iron deficiency is the main cause of anaemia but its impact remains controversial in the surgical setting. We aimed to estimate the impact of iron deficiency on in-hospital perioperative red blood cell transfusion for patients undergoing elective and urgent cardiac surgery. Secondary objectives were to identify risk factors associated with in-hospital red blood cell transfusion. METHODS: We conducted a prospective multicentre observational study in three university hospitals performing cardiac surgery. We determined iron status prior to surgery and collected all transfusion data to compare iron-deficient and iron-replete patients during hospital stay. We performed a multivariable logistic regression to compare transfusion among groups. RESULTS: Five hundred and two patients were included. A trend of low haemoglobin levels associated with iron deficiency persisted until discharge. Red blood cell transfusion was significantly higher in the group of iron deficient patients during surgery (22% vs 13%, p = 0.017), however the incidence during the whole hospital stay was 31% in the iron-deficient group, not significantly different with the non-deficient group (26%, p = 0.28). Iron deficiency was not independently associated with in-hospital red blood cell transfusion (adjusted OR = 0.85 [0.53–1.36], p = 0.49). CONCLUSIONS: In-hospital red blood cell transfusion was not significantly higher in iron-deficient patients and iron deficiency was not associated with in-hospital red blood cell transfusion in patients undergoing elective and urgent cardiac surgery. Iron deficiency was the main cause of anaemia and anaemia was a strong driver of red blood cell transfusion. Further studies should identify sub-population of iron-deficient patients which may benefit from preoperative iron deficiency management and explore the long-term impact of lower haemoglobin levels at discharge in the iron deficient population. |
format | Online Article Text |
id | pubmed-8935744 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-89357442022-03-23 The impact of iron store on red blood cell transfusion: a multicentre prospective cohort study in cardiac surgery Gaudriot, Baptiste Oilleau, Jean-Ferreol Kerforne, Thomas Ecoffey, Claude Huet, Olivier Mansour, Alexandre Verhoye, Jean-Philippe Massart, Nicolas Nesseler, Nicolas BMC Anesthesiol Research BACKGROUND: Anaemia is common prior to cardiac surgery and contributes to perioperative morbidity. Iron deficiency is the main cause of anaemia but its impact remains controversial in the surgical setting. We aimed to estimate the impact of iron deficiency on in-hospital perioperative red blood cell transfusion for patients undergoing elective and urgent cardiac surgery. Secondary objectives were to identify risk factors associated with in-hospital red blood cell transfusion. METHODS: We conducted a prospective multicentre observational study in three university hospitals performing cardiac surgery. We determined iron status prior to surgery and collected all transfusion data to compare iron-deficient and iron-replete patients during hospital stay. We performed a multivariable logistic regression to compare transfusion among groups. RESULTS: Five hundred and two patients were included. A trend of low haemoglobin levels associated with iron deficiency persisted until discharge. Red blood cell transfusion was significantly higher in the group of iron deficient patients during surgery (22% vs 13%, p = 0.017), however the incidence during the whole hospital stay was 31% in the iron-deficient group, not significantly different with the non-deficient group (26%, p = 0.28). Iron deficiency was not independently associated with in-hospital red blood cell transfusion (adjusted OR = 0.85 [0.53–1.36], p = 0.49). CONCLUSIONS: In-hospital red blood cell transfusion was not significantly higher in iron-deficient patients and iron deficiency was not associated with in-hospital red blood cell transfusion in patients undergoing elective and urgent cardiac surgery. Iron deficiency was the main cause of anaemia and anaemia was a strong driver of red blood cell transfusion. Further studies should identify sub-population of iron-deficient patients which may benefit from preoperative iron deficiency management and explore the long-term impact of lower haemoglobin levels at discharge in the iron deficient population. BioMed Central 2022-03-21 /pmc/articles/PMC8935744/ /pubmed/35313823 http://dx.doi.org/10.1186/s12871-022-01616-6 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Gaudriot, Baptiste Oilleau, Jean-Ferreol Kerforne, Thomas Ecoffey, Claude Huet, Olivier Mansour, Alexandre Verhoye, Jean-Philippe Massart, Nicolas Nesseler, Nicolas The impact of iron store on red blood cell transfusion: a multicentre prospective cohort study in cardiac surgery |
title | The impact of iron store on red blood cell transfusion: a multicentre prospective cohort study in cardiac surgery |
title_full | The impact of iron store on red blood cell transfusion: a multicentre prospective cohort study in cardiac surgery |
title_fullStr | The impact of iron store on red blood cell transfusion: a multicentre prospective cohort study in cardiac surgery |
title_full_unstemmed | The impact of iron store on red blood cell transfusion: a multicentre prospective cohort study in cardiac surgery |
title_short | The impact of iron store on red blood cell transfusion: a multicentre prospective cohort study in cardiac surgery |
title_sort | impact of iron store on red blood cell transfusion: a multicentre prospective cohort study in cardiac surgery |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8935744/ https://www.ncbi.nlm.nih.gov/pubmed/35313823 http://dx.doi.org/10.1186/s12871-022-01616-6 |
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