PREVENTT Trial: A Snapshot of Preoperative Anaemia in the United Kingdom

Butcher, Anna; Clevenger, Ben; Swinson, Rebecca; VanDyck, Laura; Klein, Andrew; Richards, Toby

doi:10.4172/2167-0870.1000269

Cited by 2 publications

(1 citation statement)

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“…The trial design was pragmatic according to normal NHS practice and included participants with anaemia defined by baseline haemoglobin concentration. At the time the study was conducted (2014–2018), pre‐operative iron status was not routinely assessed and additional testing for iron parameters to define inclusion into the trial was not feasible in the surgical pathways of the NHS in the UK [ 7 ]. Also, there is uncertainty as to the definitions of iron deficiency (absolute/functional/inflammatory iron deficiency or anaemia of chronic disease).…”

Section: Introductionmentioning

confidence: 99%

The association between iron deficiency and outcomes: a secondary analysis of the intravenous iron therapy to treat iron deficiency anaemia in patients undergoing major abdominal surgery (PREVENTT) trial

et al. 2022

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In the intravenous iron therapy to treat iron deficiency anaemia in patients undergoing major abdominal surgery (PREVENTT) trial, the use of intravenous iron did not reduce the need for blood transfusion or reduce patient complications or length of hospital stay. As part of the trial protocol, serum was collected at randomisation and on the day of surgery. These samples were analysed in a central laboratory for markers of iron deficiency. We performed a secondary analysis to explore the potential interactions between preoperative markers of iron deficiency and intervention status on the trial outcome measures. Absolute iron deficiency was defined as ferritin <30 lg.l À1 ; functional iron deficiency as ferritin 30-100 lg.l À1 or transferrin saturation < 20%; and the remainder as non-iron deficient. Interactions were estimated using generalised linear models that included different subgroup indicators of baseline iron status. Co-primary endpoints were blood transfusion or death and number of blood transfusions, from randomisation to 30 days postoperatively. Secondary endpoints included peri-operative change in haemoglobin, postoperative complications and length of hospital stay. Most patients had iron deficiency (369/452 [82%]) at randomisation; one-third had absolute iron deficiency (144/452 [32%]) and half had functional iron deficiency (225/452 [50%]). The change in pre-operative haemoglobin with intravenous iron compared with placebo was greatest in patients with absolute iron deficiency, mean difference 8.9 g.l À1 , 95%CI 5.3-12.5; moderate in functional iron deficiency, mean difference 2.8 g.l À1 , 95%CI À0.1 to 5.7; and with little change 320

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Section: Introductionmentioning

confidence: 99%