Orthopaedics

PREVENNT did not study orthopaedic patients who comprise a significant proportion of FVRH elective surgery. These patients are often truly elective and may have greater time for anaemia correction.

2 recent meta-analyses have produced different conclusions; Scrimshire et al concluded that pre-operative iron in elective THR/TKR patients’ decreases transfusion and length of stay, but acknowledged lack of high quality 6andomized controlled trials⁵. Average pre[1]operative Hb increment was 11.48g/L and IV iron was associated with a greater increment than oral iron:

 

Hb increment was greatest for for patients with lower initial haemoglobin concentration:

 

In the second meta-analysis, Smith et al found little evidence that IV iron reduces transfusion requirements, but also included emergency hip fracture patients; less than half of the included studies were classified as good quality and lack of sufficient time for haemoglobin increment was identified as a confounder⁶ .