Análisis del impacto presupuestario de la implantación de medidas de ahorro de sangre en cirugía de urgencia

Role of perioperative intravenous iron therapy in elderly hip fracture patients: a single‐center randomized controlled trial

“…The first studies involving considerable patient numbers were published by Cuenca and coworkers in 2004 9,10 and 2005, 11 García‐Erce and coworkers in 2005, 12 and Izuel‐Rami in 2005 13 and 2007 14 . These authors highlighted the need for prospective, randomized, controlled trials to confirm their preliminary findings; this was the primary purpose of this trial.…”

“…Johnson and colleagues, 35 in a study of 3625 consecutive patients undergoing hip fracture surgery, found no significant differences between the transfusion and the nontransfusion group with regard to mortality, morbidity, or infection rates. Cuenca and coworkers, 9,10 García‐Erce and coworkers, 12 and Izuel‐Rami and coworkers 14 report a significant decrease in infection rates in patients receiving IV iron therapy. These findings, however, were not confirmed either here or in more recent studies by Cuenca and coworkers, 11 Izuel‐Rami and coworkers, 13 and García‐Erce and coworkers, 15 in which urinary, respiratory, and surgical wound infection rates were similar in treated and untreated groups.…”

“…These findings were confirmed in this study: patients with intracapsular fractures and patients with baseline Hb values of more than 12 g/dL benefited from IV iron administration, with a significant decrease in the percentage of patients requiring transfusion and in the mean number of concentrates per patient. In subsequent studies by Izuel‐Rami and colleagues 13,14 and García‐Erce and colleagues, 12,15 recombinant human EPO was administered to patients with baseline Hb levels of lower than 13 g/dL (a standard procedure in patients undergoing orthopedic surgery in Europe); a significant reduction in transfusion requirements was recorded in all patients.…”

“…[4][5][6][7] Over the past 5 years, a number of studies have focused on the potential influence of IV iron therapy, either alone or combined with EPO, on transfusion requirements in patients undergoing surgery for hip fracture repair. [8][9][10][11][12][13][14][15] The authors conclude that, while iron therapy appears to be useful in certain types of patient, randomized controlled trials are required to confirm these findings.…”

“…Countless reports in the literature testify to the value of IV iron therapy, either alone or in combination with erythropoietin (EPO), in scheduled digestive, gynecologic or obstetric, vascular, and heart surgery 4‐7 . Over the past 5 years, a number of studies have focused on the potential influence of IV iron therapy, either alone or combined with EPO, on transfusion requirements in patients undergoing surgery for hip fracture repair 8‐15 . The authors conclude that, while iron therapy appears to be useful in certain types of patient, randomized controlled trials are required to confirm these findings.…”