Efficacy and Safety of Iron Supplementation for the Elderly Patients Undergoing Hip or Knee Surgery: A Meta-Analysis of Randomized Controlled Trials

Ferric carboxymaltose with or without erythropoietin in anemic patients with hip fracture: a randomized clinical trial

“…Nevertheless, this hematopoietic effect was not correlated to an objective and on‐time clinical benefit as demonstrated by primary and secondary endpoints. These results have been observed by other authors when analyzing patients with HF . However, the effects of these analytical differences, in additional more subtle clinical and functional variables, have not been determined in this study and remain to be evaluated in ongoing or future trials …”

“…Another weakness could be the sample size for comparing the number of RBC transfusions needed among the arms; this secondary endpoint could have relevance from the perspective of blood saving strategies and remains to be assessed. Finally, the establishment of a homogeneous restrictive transfusion protocol could raise the question of being harmful for patients, but the results have shown similar or lower mortality and medical complications rates with respect to previous reports …”

Optimizing preoperative hemoglobin in major orthopaedic surgery using intravenous iron with or without erythropoietin. An epidemiologic study

“…20 Diagnosis of iron deficiency anemia in elderly patients, however, is more complex, and it is harder to predict whether iron therapy will improve preoperative Hb levels. 12,32 We also found that the anemia classification parameters usually used by clinicians, 33 such as ferritin concentration, TSAT, and MCV, were of little use in establishing baseline iron levels, in indicating the need for iron therapy and associated rHuEPO in elderly patients. In our study, less than 25% of patients presented low MCH, and less than 20% showed microcytosis.…”

Optimización de la hemoglobina preoperatoria en cirugía ortopédica mayor utilizando hierro intravenoso con o sin eritropoyetina. Estudio epidemiológico

“…Es improbable que ocurra un aumento de Hb en aquellos pacientes con reservas de hierro suficientes y un buen estado funcional. En pacientes jóvenes se diagnostica muy fácilmente un défi-cit de hierro por metrorragia 31 y responde muy bien al tratamiento 20 , mientras que el diagnóstico de anemia por déficit de hierro es más complejo en el anciano, haciendo difícil predecir si el tratamiento con hierro mejorará los niveles de Hb preoperatoria 12,32 .…”