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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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