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4CPS-257 Preoperative intravenous iron to treat anaemia before major orthopedic surgery
  1. S Asenjo Segovia,
  2. M Sarobe Carricas,
  3. M Noceda Urarte
  1. Hospital Universitario de Navarra, Pharmacy, Pamplona, Spain


Background and Importance Preoperative anaemia , is a risk factor for poor outcome in patients undergoing surgery. Sufficient data exist to support intravenous iron as efficacious and safe if surgery is planned for < 2-3 weeks after the diagnosis of iron deficiency. Treatment of preoperative iron deficiency anaemia should be implemented as early as posible before the scheduled surgical procedure,most major surgery is elective.

Aim and Objectives The purpose of this study is to review the clinical effectiveness of IVI administered preoperatively for iron deficient in adult patients undergoing elective orthopedic surgery

Material and Methods Retrospective Observational study conducted between January 2021 and December 2021

Eligible participants, identified in preoperative hospital visit were older than 18 years of age and had haemoglobin less than 13 g/dL for men and 12 g/dL por women.

Preoperative assessment visit scheduled 1-2 weeks before surgery, able to receive infusion at least 7 days before the planned operation date.

Intervention: Intravenous iron was administered as a single 500-1000 mg dose of ferric carboxymaltose (FCM)

Endpoints included: demografic characteristics, clinical effectiveness (hemoglobin level before surgery >13 g/dL), time span between first FCM administration and surgery, safety (rate of adverse events).

Limitations: no evidence with respect to outcomes such as quality of life, post-operative complications, morbidity and mortality were identified.

Results We recruited 165 adults patients (86,6% female and 13,3% male). The median age was 71,1 years. The type of orthopedic surgery was: hip 66 (40%), knee 77 (46,7%) and spine 18 (10,9%). Treatment with intravenous iron were administrated en 79 patients (48%) between 7-15 days before surgery.

Intravenous iron was administrated as a single 500 mg dose in 44 patients (26,6%) and a single 1000 mg in 121 pacientes (73,3%)

The day of the surgery, 7,27% of the patients reached haemoglobin concentration levels ≥ 13 g/dL

Patients were monitored for adverse events or signs of hypersensitivity during and for at least 30 min after treatment and no severe adverse events related to FMC ocurred

Conclusion and Relevance The primary results of our study show no evidence of clinical benefit in giving intravenous iron preoperatively to patients undergoing major surgery

The study suggests that current protocol on preoperative iron therapy should be revised to improve the results.

Conflict of Interest No conflict of interest

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