title: Is intravenous iron useful for reducing transfusions in surgically treated colorectal cancer patients?
abstract: BACKGROUND
  The goal of the present study was to determine whether the intravenous administration of iron in the postoperative period of colon cancer surgical patients suffices to reduce the number of transfusions necessary.
  
  
  METHODS
  The study was designed as a retrospective observational study conducted over a three-year period. A paired case-control design was used to analyze the effect of postoperative iron on patients' blood transfusion needs. Two groups were established (the case group, which received postoperative iron and the control group, which did not) and matched for age (± 3 years), gender, type of operation, tumor stage, and surgical approach. Of 342 patients who underwent operation, 104 paired patients were obtained for inclusion in this study (52 in each group). A second analysis was made to assess the effect of intravenous iron on the evolution of hemoglobin between the first postoperative day and hospital discharge in the subgroup of patients with reduction in hemoglobin, in subjects without preoperative or postoperative transfusions. Finally, a total of 71 patients were paired in two groups: 37 and 31 patients in case and control, respectively.
  
  
  RESULTS
  The mean hemoglobin concentration at discharge for the case group was 10 ± 1.1 g/dl, vs. 10.6 ± 1.2 in the controls (P = 0.012). The number of transfusions in the case group was 3 ± 1.6, vs. 3.3 ± 3 in the control group (P = 0.682). Thus, 28.8 % of the patients in the case group received transfusions, versus 30.8 % of those in the control group (P = 0.830). In the second analysis, the decrease in hemoglobin concentration was 0.88 g/dl and 0.82 g/dl in case and control, respectively.
  
  
  CONCLUSIONS
  Intravenous iron does not appear to reduce the blood transfusion requirements in the postoperative period of colorectal surgery patients with anemia. We consider that further studies are needed to more clearly define the usefulness of intravenous iron in reducing the transfusion needs in such patients.
authors.affiliation: Pharmacy Service, Morales Meseguer General University Hospital, C/ Marqués de los Vélez, s/n, 30008, Murcia, Spain. jtitos2@hotmail.com
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Titos-Arcos
authors.forename: Victoriano
authors.initials: V
authors.lastname: Soria-Aledo
authors.forename: Andrés
authors.initials: A
authors.lastname: Carrillo-Alcaraz
authors.forename: María
authors.initials: M
authors.lastname: Ventura-López
authors.forename: Sonsoles
authors.initials: S
authors.lastname: Palacios-Muñoz
authors.forename: Enrique
authors.initials: E
authors.lastname: Pellicer-Franco
mesh_terms: D000368:Aged; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007262:Infusions, Intravenous; D007501:Iron / Q000008:administration & dosage*; D008297:Male; D009367:Neoplasm Staging; D011184:Postoperative Period; D012189:Retrospective Studies
chemical_list: D006454:Hemoglobins; D007501:Iron