Results of an anaemia treatment protocol complementary to blood transfusion in elderly patients with hip fracture

Sierra, Teresa Pareja; Martín, Irene Bartolomé; Solís, Juan Rodríguez; Sanz, María Dolores Morales; Torralba, Miguel; Goitiandia, Leopoldo Ángel Barcena; Calvo, M. Isabel Brincones

doi:10.1016/j.regg.2019.05.003

Cited by 8 publications

(20 citation statements)

References 38 publications

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“…The combined use of IV iron and erythropoietin (EPO) did not reduce the percentage of transfused patients in two cohort studies [112,113] but it did reduce the number of RBC units required. Patients in the intervention group showed improved functional recovery at 3 and 6 months after the fracture, measured with the Barthel index and the Functional Ambulation Categories (FAC scale) [112]. A retrospective study compared RBC transfusion with a patients treated with iron and EPO [114].…”

Section: Anemia and Patients Blood Managementmentioning

confidence: 99%

Orthogeriatric Management: Improvements in Outcomes during Hospital Admission Due to Hip Fracture

Tarazona-Santabalbina

Ojeda-Thies

Rodríguez

et al. 2021

IJERPH

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Hip fractures are an important socio-economic problem in western countries. Over the past 60 years orthogeriatric care has improved the management of older patients admitted to hospital after suffering hip fractures. Quality of care in orthogeriatric co-management units has increased, reducing adverse events during acute admission, length of stay, both in-hospital and mid-term mortality, as well as healthcare and social costs. Nevertheless, a large number of areas of controversy regarding the clinical management of older adults admitted due to hip fracture remain to be clarified. This narrative review, centered in the last 5 years, combined the search terms “hip fracture”, “geriatric assessment”, “second hip fracture”, “surgery”, “perioperative management” and “orthogeriatric care”, in order to summarise the state of the art of some questions such as the optimum analgesic protocol, the best approach for treating anemia, the surgical options recommendable for each type of fracture and the efficiency of orthogeriatric co-management and functional recovery.

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Section: Anemia and Patients Blood Managementmentioning

confidence: 99%

Orthogeriatric Management: Improvements in Outcomes during Hospital Admission Due to Hip Fracture

Tarazona-Santabalbina

Ojeda-Thies

Rodríguez

et al. 2021

IJERPH

View full text Add to dashboard Cite

show abstract

“…The combined use of IV iron and erythropoietin (EPO) did not reduce the percentage of transfused patients in two cohort studies [111,112] but it did reduce the number of RBC units required. Patients in the intervention group showed improved functional recovery at 3 and 6 months after the fracture, measured with the Barthel index and the Functional Ambulation Categories (FAC scale) [111]. A retrospective study compared RBC transfusion with a patients treated with iron and EPO [113].…”

Section: Anemia and Patients Blood Managementmentioning

confidence: 99%

Orthogeriatric Care: Reviewing Improvements in Outcomes

Tarazona-Santabalbina¹,

Ojeda-Thies²,

Rodríguez³

et al. 2021

Preprint

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Hip fractures are an important socio-economic problem in western countries. Over the past 60 years orthogeriatric care has improved the management of older patients admitted to hospital after suffering hip fractures. Orthogeriatric co-management units have increased quality of care, reducing adverse events during acute admission, length of stay, both in-hospital and mid-term mortality, as well as healthcare and social costs. Nevertheless, a large number of areas of controversy regarding the clinical management of older adults admitted due to hip fracture remain to be clarified. This narrative review, centered in the last 5 years, combined the search terms “hip fracture”, “geriatric assessment”, “second hip fracture”, “surgery”, “perioperative management” and “orthogeriatric care”, in order to summarise the state of the art of some questions such as the optimum analgesic protocol, the best approach for treating anemia, the surgical options recommendable for each type of fracture and the efficiency of orthogeriatric co-management and functional recovery.

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“… No significant difference in RBC transfusions between groups 3.0% AE-related treatment suspension with IS (one skin rash, two general discomfort); overall, 14.8% infections (mainly superficial surgical wound infections 5.6%) Garrido-Martín et al (2012) [ 109 ] Perioperative cardiac surgery Hb < 8 g/dL coronary patients; < 7 g/dL valve surgery patients IS: 54 Oral iron: 53 Placebo: 52 IS: 100 mg × 3 during perioperative period Oral iron: 105 mg q.d. pre- and postoperatively, and 1 month after discharge No between-group differences in Hb, HCT, or transfusions Neither IS nor oral iron therapy were effective in correcting anemia after cardiac surgery No AEs with IS Shin et al (2019) [ 110 ] Perioperative orthopedic surgery Meta-analysis 1869 patients from 12 clinical trials Various IV iron Perioperative IV iron during orthopedic surgery, especially postoperatively, appears to reduce the proportion of patients transfused and units transfused, with shorter length of hospital stay and decreased infection rate Xu et al (2019) [ 111 ] Postoperative cardiac valvular surgery Hb < 12.0 g/dL (women) or < 13.0 g/dL (men) SF 30–100 ng/mL or TSAT < 20% IS: 75 Placebo: 75 200 mg e.o.d., until total iron deficiency was achieved Hb concentration and proportion of patients with anemia corrected or achieving Hb increments > 2.0 g/dL were significantly greater for IS than placebo 14 days postoperatively, but not 7 days postoperatively SF were significantly higher for IS versus placebo 7 days and 14 days postoperatively IS was well tolerated: no AEs or infusion reactions were observed Muñoz et al (2014) [ 112 ] Perioperative orthopedic surgery Hb ≥ 10.0 g/dL IS: 1142 IS + EPO: 351 FCM: 45 No iron: 1009 100–200 mg up to 3 × (2–5 days preoperatively or 2–3 days postoperatively) Very short-term perioperative IV iron in major lower limb orthopedic procedures is associated with reduced allogeneic blood transfusion rates and length of hospital stay In patients with hip fracture, IV iron is also associated with a reduction in postoperative nosocomial infection No significant AEs with IV iron Pareja Sierra et al (2019) [ 113 ] Perioperative hip fracture Des...…”

Section: Pharmacokinetics and Pharmacodynamicsmentioning

confidence: 99%

“…The safety profile is therefore well established in many different patient groups, including CKD, GI disorders, women’s health disorders, oncology, cardiology, and for patient blood management (Tables 2 , 3 , 4 , 5 , 6 , 7 ). To date, more than 50 published clinical studies, covering numerous patient populations, have reported safety outcomes with administration of iron sucrose; 18 of these studies have been reported in the last 5 years [ 40 , 46 , 47 , 50 , 52 , 53 , 58 , 66 , 73 , 74 , 111 , 113 , 114 , 126 , 127 , 129 – 131 ].…”

Section: Safety and Tolerability Of Iron Sucrosementioning

confidence: 99%

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Iron Sucrose: A Wealth of Experience in Treating Iron Deficiency

et al. 2020

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Iron deficiency and iron-deficiency anemia are associated with increased morbidity and mortality in a wide range of conditions. In many patient populations, this can be treated effectively with oral iron supplementation; but in patients who are unable to take or who do not respond to oral iron therapy, intravenous iron administration is recommended. Furthermore, in certain conditions, such as end-stage kidney disease, chronic heart failure, and inflammatory bowel disease, intravenous iron administration has become first-line treatment. One of the first available intravenous iron preparations is iron sucrose (Venofer ® ), a nanomedicine that has been used clinically since 1949. Treatment with iron sucrose is particularly beneficial owing to its ability to rapidly increase hemoglobin, ferritin, and transferrin saturation levels, with an acceptable safety profile. Recently, important new data relating to the use of iron sucrose, including the findings from the landmark PIVOTAL trial in patients with end-stage kidney disease, have been reported. Several years ago, a number of iron sucrose similars became available, although there have been concerns about the clinical appropriateness of substituting the original iron sucrose with an iron sucrose similar because of differences in efficacy and safety. This is a result of the complex and unique physicochemical properties of nanomedicines such as iron sucrose, which make copying the molecule difficult and problematic. In this review, we summarize the evidence accumulated during 70 years of clinical experience with iron sucrose in terms of efficacy, safety, and cost-effectiveness.

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Results of an anaemia treatment protocol complementary to blood transfusion in elderly patients with hip fracture

Cited by 8 publications

References 38 publications

Orthogeriatric Management: Improvements in Outcomes during Hospital Admission Due to Hip Fracture

Orthogeriatric Management: Improvements in Outcomes during Hospital Admission Due to Hip Fracture

Orthogeriatric Care: Reviewing Improvements in Outcomes

Iron Sucrose: A Wealth of Experience in Treating Iron Deficiency

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