Abstract
Background
Older patients often have iron deficiency anemia before surgery, which can be effectively
treated with intravenous iron supplementation (IVIS). Anemia and blood transfusions
are associated with an increased risk of delirium. The aim of this research was to
assess the effectiveness and safety of using IVIS in a prehabilitation program.
Material and methods
Patients ≥70 y who underwent abdominal surgery between November 2015 and June 2018
were included in this single-center prospective cohort study. All patients were prehabilitated;
however, only anemic patients received a single dose of 1000 mg intravenous iron (ferric
carboxymaltose) to increase preoperative hemoglobin levels (IVIS group). Nonanemic
patients received standard care (SC). The hemoglobin levels (primary outcome) were
assessed at the outpatient clinic visit, at admission, and at discharge. Secondary
outcomes were postoperative delirium, postoperative anemia, blood transfusion, complications
other than delirium, and length of hospital stay. All outcomes were compared between
the IVIS group and SC group.
Results
Of all patients (n = 248), 97 anemic patients received IVIS (39%). Of the anemic patients, 50 patients
(52%) had iron deficiency. Initial differences in hemoglobin concentrations between
the IVIS group and SC group at T1 and T2 (7.2 versus 8.8; P < 0.001 and 7.4 versus 8.6; P = 0.023, respectively) were no longer present at discharge (6.6 versus 7.2; P = 0.35). No statistically significant differences were observed for all secondary
outcomes between the IVIS group and the SC group. No infusion-related adverse events
occurred.
Conclusions
Adding IVIS to prehabilitation programs is safe and diminishes differences in these
concentrations between preoperatively anemic and nonanemic patients. IVIS may be worthwhile
as an additional component of prehabilitation programs. Results merit further investigation.
Keywords
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Article Info
Publication History
Published online: August 17, 2020
Accepted:
July 19,
2020
Received in revised form:
July 14,
2020
Received:
May 27,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
