Intravenous transfusion of iron sucrose reduces blood transfusions and improves postoperative anaemia after a second thoracotomy: a propensity-score matching study

Abstract

Objective: To evaluate the efficacy of intravenous iron sucrose (IS) in the perioperative period of a second thoracotomy after open-heart surgery. Methods: This study enrolled patients that underwent a second thoracotomy after previous open-heart surgery. Propensity-score matching was used to match patients that received oral iron therapy with those that received IS after admission. The baseline demographic and clinical characteristics, perioperative data and adverse outcomes were compared between these two matched groups. Results: The study enrolled 447 patients: of these, 148 received oral iron therapy and effective dietary guidance; and 299 patients received 300 mg IS per week. After matching the propensity scores, there were no significant differences between the two groups in terms of age, sex, smoking history, incidence of major cardiac adverse events, Euro-score, time between the two thoracotomies, application of recombinant erythropoietin, haemoglobin (Hb) on admission and red blood cell (RBC) count on admission. The differences between the two groups after propensity-score matching in terms of the amount of RBC input and Hb after the operation were significant.

Current concepts in evaluation and management of preoperative anaemia in patients undergoing thoracic surgery

“…avoids the gastrointestinal side effects and allows for more rapid correction of iron stores and anaemia. Luo et al [27] showed significant decreases in red blood cell transfusion and increases in Hgb following iron sucrose infusion in patients having repeat thoracotomy following cardiac surgery. In addition, Triphaus et al [28 ▪ ] showed that preoperative iron supplementation reduced red blood cell transfusion and hospital length of stay (LOS) in patients with IDA having major surgery compared with patients with IDA who were not treated with iron.…”