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A Prospective Randomized Controlled Trial to Assess the Effect of Intravenous versus Oral Iron Therapy in the Treatment of Orthopaedic Preoperative Anaemia

Citation

Khalafallah, A and Al-Barzan, AM and Chan, J and Sung, M and Bates, G and Ahuja, KDK and Batten, JC and Einoder, B, A Prospective Randomized Controlled Trial to Assess the Effect of Intravenous versus Oral Iron Therapy in the Treatment of Orthopaedic Preoperative Anaemia, Journal of Blood Disorders and Transfusion, 3, (4) pp. 1-6. ISSN 2155-9864 (2012) [Refereed Article]


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Copyright Statement

Copyright 2012 Khalafallah A, et al. Licenced under Creative Commons Attribution 3.0 http://creativecommons.org/licenses/by-nc/3.0/us/

DOI: doi:10.4172/2155-9864.1000127

Abstract

Abstract Background: Improving preoperative anaemia is associated with a better surgical outcome. There is lack of data regarding treatment of preoperative anaemia with intravenous versus oral iron. Objective: Assessment of efficacy of oral iron sulphate versus a single intravenous iron polymaltose and subsequent effect on perceived quality of life in both treatment groups. Patients and methods: We conducted a prospective randomised controlled trial with iron therapy for the treatment of Iron Deficiency Anaemia (IDA) patients who were undergoing elective joint arthroplasty. At a single institution, we recruited 44 patients who were randomized to a single intravenous iron polymaltose infusion (16/22) versus oral daily iron sulphate (17/22). Median age was 68 years (range, 45-91) with a male to female ratio of 14:19. Results: After iron therapy, the immediate mean preoperative Hb was increased to 128 g/L (SD 11.05) in the IV iron group versus 118 g/L (SD 9.23) in the oral iron group (p=0.01) compared to 116 g/L (SD 8.46) in the control group (p=0.001). The average length of stay in the hospital for the IV iron group was 6 days (SD 2.51) compared to 8 days (SD 3.62) in the oral iron group and 8 days (SD 4.18) in the control group (p=0.04). Average transfused blood units were 1.5 units in the IV iron group versus 2 units in the oral iron group (p=0.09) and 2.4 units in the control group (p = 0.04). There was a significant improvement of the symptoms of anaemia (p=0.03) after treatment in the IV versus oral iron group with further improvement at 3 months follow-up (p=0.003). Conclusion: Our data suggest that IV iron therapy is superior to oral iron in improving preoperative Hb and hence overall outcome for patients with preoperative IDA. Further trials that aim to improve and optimize preoperative and postoperative Hb are warranted.

Item Details

Item Type:Refereed Article
Keywords:Preoperative anaemia; Oral iron; Intravenous iron; Orthopaedic surgery; Blood transfusion; Outcome; Quality of life
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Haematology
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Blood Disorders
Author:Khalafallah, A (Professor Alhossain Khalafallah)
Author:Al-Barzan, AM (Dr Abdul Majeed)
Author:Chan, J (Dr Jon Ho Chan)
Author:Sung, M (Dr Mei-Jo Sung)
Author:Bates, G (Mr Gerald Bates)
Author:Ahuja, KDK (Dr Kiran Ahuja)
ID Code:80057
Year Published:2012
Deposited By:Health Sciences A
Deposited On:2012-10-19
Last Modified:2013-05-10
Downloads:261 View Download Statistics

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