[Safety and usefulness of parenteral iron in the management of anemia due to hip fracture in the elderly].
OBJECTIVE
An important percentage of patients with hip fracture need allogeneic transfusion to resolve their perioperative anemia. Our goal was to determine the safety profile and usefulness of parenteral iron in order to avoid allogeneic transfusions in trochanteric hip fracture (THF).


METHODS
A pseudo-experimental study was performed comparing a historic THF group (n = 104) with another group (n = 23) treated with parenteral iron (Venofer) (doses of 100 mg). Patients who had primary blood diseases or were receiving anticoagulation therapy were excluded. Age, gender, elapsed time, type of THF (international AO classification), surgical procedure, transfusion procedure and quantity, hemoglobin and hematocrit at days 0 and +2 (if a surgical procedure was not performed) and postoperatively were examined. We also analyzed the morbidity (post-surgical infection) and hospital stay and mortality rate at the first month.


RESULTS
We have not observed any adverse reactions upon iron administration. The iron group was transfused less times (39.1% vs. 56.7%) and had lower morbidity (infection) (20.3% vs. 35.4%) (p = 0.04), lower mortality (13% vs. 16.3%), less blood consumption (0.87 vs. 1.31 units) and less stay (13.7 vs. 14.3 days).


CONCLUSIONS
Parenteral administration of iron could be a safe and effective way to avoid or reduce allogeneic blood transfusions in THF patients. The reduction in the transfusional rate in the iron treated group is also accompanied by a reduction in the morbidity, infection rate, mortality rate and hospital stay.
Cuenca Espiérrez
Jorge
J
Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Miguel Servet, Zaragoza, Spain.
García Erce
José Antonio
JA
Martínez Martín
Angel A
AA
Solano
Víctor Manuel
VM
Modrego Aranda
Francisco Javier
FJ
D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000209:etiology / Q000517:prevention & control*; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage*; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid; D006397:Hematinics / Q000008:administration & dosage*; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D007262:Infusions, Intravenous; D007501:Iron / Q000008:administration & dosage*; D008297:Male; D013395:Sucrose / Q000008:administration & dosage*
D005290:Ferric Compounds; D006397:Hematinics; D013395:Sucrose; D007501:Iron; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid
Seguridad y eficacia del hierro intravenoso en la anemia aguda por fractura trocantérea de cadera en el anciano.