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4CPS-252 Oral and intravenous iron in the treatment of perioperative anaemia
  1. M Fernández González1,
  2. M Alonso Moreno1,
  3. H Rodríguez Ramallo1,
  4. JL Pérez Blanco1,
  5. P Ciudad Gutierrez1,
  6. ME Mingot Castellano2,
  7. R Rubio Romero3
  1. 1Hospital Universitario Virgen del Rocío, Pharmacy, Seville, Spain
  2. 2Hospital Universitario Virgen del Rocío, Haemathology, Seville, Spain
  3. 3Hospital Universitario Virgen del Rocío, Anaesthesia, Seville, Spain


Background and importance Anaemia is common in the perioperative period and is associated with worse patient outcomes. Carboxymaltose intravenous iron (CII) administration contributes to its correction, at the expense of greater cost. Oral iron might be a more efficient alternative, so an assessment of effectiveness is needed.

Aim and objectives Assessment of effectiveness of oral iron and CII as combined therapy in the treatment of perioperative anaemia in surgical patients.

Material and methods This was an observational, retrospective, single centre study. Data were obtained from medical prescription covering a 2-year period (January 2017–December 2018). Surgical patients who received CII and oral iron in combination during the perioperative period were included.

The following variables were collected: sex, age, type of surgery, haemoglobin (Hb) before and after treatment with CII and oral iron, and duration of treatment.

Median and range was calculated for quantitative variables. Percentage was selected as the descriptive measure for discrete variables.

The primary variable considered to assess the effectiveness of the treatments was an increase of Hb >1 g/dL in the preoperatory and postoperatory periods in comparison with basal Hb in both stages.

Results A total of 37 patients who received CII and oral iron together during the perioperatory period were included (18 in preoperatory period and 34 in postoperatory). Median age was 47 (40–59) years. 85.3% (n=29) of the patients were women. Most common types of surgery were gynaecological (67%) and digestive (14%).

In the preoperatory period,18 patients who received oral iron had a basal Hb of 10.2 (9.0–10.6) g/dL. After 76.5 (28.5–137) days of treatment, no increase of Hb was observed (10.2 g/dL, 8.4–11.2). Only 11.1% (n=2) of patients obtained increases of Hb >1 g/dL. After posterior administration of CII, Hb values reached 11.0 (9.5–11.7) g/dL. An increase of Hb >1 g/dL was found in 27.8% (n=5) of patients.

In the postoperatory period, 34 patients who received oral iron had a basal Hb of 10.6 (9.5–11.5) g/dL, reaching a value of Hb of 12.6 (11.0–13.0) g/dL after 56 (48.3–90) days of treatment. 52.9% (n=18) of patients obtained increases of Hb >1 g/dL.

Conclusion and relevance CII treatment was more effective than oral iron in the perioperative period.

Oral iron treatment was more effective in the postoperatory period in comparison with the preoperatory period.

Conflict of interest No conflict of interest

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