title: Optimizing preoperative haemoglobin in major orthopaedic surgery using intravenous iron with or without erythropoietin. An epidemiologic study.
abstract: OBJECTIVE
  To evaluate the effectiveness of intravenous iron treatment, with or without associated erythropoietin (rHuEPO), measured as haemoglobin (Hb) increase. The relationships between the Hb increase and parameters used to evaluate anaemia were analysed.
  
  
  METHODS
  Retrospective observational study carried out in two third-level hospitals between January 2005 and December 2009. The study included patients with iron deficiency anaemia scheduled for elective orthopaedic surgery and treated with intravenous iron sucrose alone or associated with rHuEPO. Treatment efficacy was analysed based on the Hb increase from baseline to just before surgery.
  
  
  RESULTS
  A total of 412 patients who received a median of 800mg of iron sucrose were included; 125 of them (30.4%) additionally received 2.4 vials of rHuEPO. The Hb increase was 0.8 (1.1) g/dL in patients treated with intravenous iron and 1.5 (1.3) g/dL in those additionally given rHuEPO(P<.01). The percentage of hypochromic red blood cells (r=0.52) and soluble transferrin receptor (r=0.59) value were significantly correlated to the Hb increase in patients receiving iron.
  
  
  CONCLUSIONS
  In patients with iron deficiency anaemia, the effectiveness of iron sucrose treatment to optimize Hb before surgery was moderate; adjuvant administration of erythropoietin improved the results. Determination of functional iron status parameters may improve the treatment effectiveness.
authors.affiliation: Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Clínic, Barcelona, España. Electronic address: mbasora@clinic.ub.es.
authors.forename: M
authors.initials: M
authors.lastname: Basora
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario Vall d'Hebron, Barcelona, España.
authors.forename: M J
authors.initials: MJ
authors.lastname: Colomina
authors.affiliation: Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Clínic, Barcelona, España.
authors.forename: M
authors.initials: M
authors.lastname: Tio
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario Vall d'Hebron, Barcelona, España.
authors.forename: L
authors.initials: L
authors.lastname: Mora
authors.affiliation: Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Clínic, Barcelona, España.
authors.forename: G
authors.initials: G
authors.lastname: Sánchez-Etayo
authors.affiliation: Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Clínic, Barcelona, España.
authors.forename: F
authors.initials: F
authors.lastname: Salazar
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario Vall d'Hebron, Barcelona, España.
authors.forename: E
authors.initials: E
authors.lastname: Ciércoles
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario Vall d'Hebron, Barcelona, España.
authors.forename: M
authors.initials: M
authors.lastname: Paños
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario Vall d'Hebron, Barcelona, España.
authors.forename: E
authors.initials: E
authors.lastname: Guerrero
authors.affiliation: Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Clínic, Barcelona, España.
authors.forename: R
authors.initials: R
authors.lastname: Berge
mesh_terms: D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000097:blood* / Q000188:drug therapy*; D016021:Epidemiologic Studies; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage*; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid / Q000008:administration & dosage*; D006397:Hematinics / Q000008:administration & dosage*; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D019637:Orthopedic Procedures; D011300:Preoperative Care; D012189:Retrospective Studies
chemical_list: D005290:Ferric Compounds; D006397:Hematinics; D006454:Hemoglobins; D004921:Erythropoietin; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid
keywords: Anaemia; Anemia ferropénica; Deficiencia de hierro; Eritropoyetina; Erythrocyte indices; Erythropoietin; Iron-deficiency; Orthopaedic procedures; Ortopedia; Período preoperatorio; Preoperative period; Receptores; Receptors; Transferrin; Transferrina; Índices eritrocitarios