Preoperative intravenous iron administration corrects anemia and reduces transfusion requirement in women undergoing abdominal hysterectomy

Abstract

SUMMARY We prospectively investigated the utility of preoperative intravenous (IV) iron treatment to increase hemoglobin (Hb) levels and reduce the need for transfusion in women with iron deficiency anemia (IDA) or iron deficiency (ID) scheduled for elective abdominal hysterectomy. Seventy‐five women with ID or IDA were enrolled in the study. Women having their surgical procedure at least 1 month after preoperative assessment received IV iron sucrose during 2–4 weeks (IV iron group, n = 31). Women having their surgical procedure a few days after preoperative assessment did not receive IV iron (control group, n = 44). At baseline, there were no differences between the two groups in terms of weight or age, prevalence of anemia, Hb levels or iron laboratory parameters. IV iron sucrose (760 ± 290 mg) increased preoperative Hb (ΔHb: 2.2 ± 1.2 g/dL; P < 0.001) and reduced postoperative transfusion rates when compared with the control group (32%vs. 0%, respectively; P < 0.001). In addition, fewer women from the IV iron group were anemic on postoperative day 21 (23%vs. 68%, respectively; P < 0.01). No life‐threatening iron sucrose adverse effect was observed. Because of the rapid increase in Hb levels, IV iron sucrose administration seems to be an effective approach for treating preoperative anemia and reducing transfusion rates in this female population.

Role of iron replacement in the management of preoperative anemia

“…Our results were in accordance with those previously published about the administration of iron sucrose in orthopedic and gynecologic patients 39,41,42 . However, data from a randomized controlled trial conducted by Edwards et al 43 .…”

Efficacy and safety of IV ferumoxytol for adults with iron deficiency anemia previously unresponsive to or unable to tolerate oral iron

“…Anemia impacts patients' quality of life and is associated with a variety of well‐recognized clinical consequences, including fatigue, low energy, exercise intolerance, decreased physical functioning, decreased vitality, feeling cold, reduced cognitive abilities, and cardiac dysfunction , as well as increased hospitalizations, blood transfusions, operative morbidity, and child and maternal mortality .…”

Randomized clinical trial of preoperative intravenous iron sucrose to reduce blood transfusion in anaemic patients after colorectal cancer surgery

“…The iron dextran form, although demonstrating efficacy, resulted in an alarming rate of anaphylaxis, thereby precluding its use16. More recently, observational studies have shown a iron sucrose complex to reduce ABT and to correct anaemia following arthroplasty17, 18 and hysterectomy19.…”