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Preoperative IV Iron Treatment Better for Iron Deficiency Anemia

IV iron associated with significant reduction in 30-day postoperative mortality and morbidity compared with RBC transfusion

By Elana Gotkine HealthDay Reporter

WEDNESDAY, Aug. 7, 2024 (HealthDay News) — For patients with preoperative iron deficiency anemia (IDA), intravenous (IV) iron treatment is associated with a significant reduction in 30-day postoperative mortality and morbidity compared with red blood cell (RBC) transfusion, according to research published online July 22 in Anesthesia & Analgesia.

Una E. Choi, from the Johns Hopkins University School of Medicine in Baltimore, and colleagues conducted a propensity score-matched retrospective cohort analysis from 2003 to 2023 to examine trends in preoperative IDA treatment among surgical patients diagnosed with IDA within three months preoperatively. A cohort of 77,179 patients with preoperative IDA who were treated with preoperative IV iron but not RBCs was compared to a cohort of 77,179 patients receiving preoperative RBCs but not IV iron.

The researchers found that preoperative IV iron was associated with a lower risk for postoperative mortality and a lower risk for postoperative composite morbidity compared with RBC transfusion (relative risks, 0.63 and 0.76, respectively). IV iron was associated with higher hemoglobin in the 30-day postoperative period (10.1 ± 1.8 versus 9.4 ± 1.7 g/dL) and a reduced incidence of postoperative RBC transfusion (relative risk, 0.30) compared with RBC transfusion.

“This change in practice represents a promising opportunity to continue to improve outcomes and reduce avoidable blood transfusions along with their associated costs,” the authors write.

One author disclosed ties to Octapharma; another author disclosed ties to Haemonetics.

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