IV Iron Administered Post-Op May Improve Surgical Outcomes

MedicalResearch.com Interview with:
Clinical Professor Alhossain A.Khalafallah
Menzies Institute for Medical Research,
University of Tasmania, Australia
Consultant Haematologist
Senior Staff Specialist
Launceston General Hospital,

MedicalResearch.com: What is the background for this study?

1. Iron deficiency is one of the most common nutritional deficiencies worldwide, affecting up to one third of the population worldwide.
2. Prevalence of anaemia in orthopaedic surgery ranges between 10-20% with the main cause of anaemia identified as nutritional deficiency.
3. New intravenous iron preparations have been developed at a higher purchase price than oral iron. Iron carboxymaltose, as one example, remains underutilised in the treatment of perioperative anaemia.
4. To our knowledge, this study is the first to compare the efficacy, safety and long term effect on iron stores and length of hospital stay in the postoperative anaemia setting.

MedicalResearch.com: What are the main findings?

Response: This innovative translational research focused on improving outcomes of perioperative anaemia. There are several findings emerging from this research.
1. Managing efficiently postoperative anaemia with intravenous iron carboxymaltose achieved better haemoglobin levels and improved iron stores.
2. Accordingly, there was less blood transfusion, less infection rate and less hospital stay in the group of patients who received intravenous iron carboxymaltose compared to the observation of the standard care group.
3. The iron carboxymaltose was well tolerated by all patients.

MedicalResearch.com: What should readers take away from your report?

Response: This novel research highlights several factors:

1. The importance of early diagnosis of iron deficiency anaemia by integration of iron studies together with full blood count in the perioperative setting.
2. Application of an efficient and safe iron infusion when iron deficiency anaemia diagnosed in postoperative setting leads to improved outcomes of surgical procedures.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?


1. Screening of all patients who undergo major surgical procedures for postoperative iron deficiency anaemia by requesting iron studies and not only relying on haemoglobin in the full blood count.
2 Integration of intravenous iron as part of blood management policies.
3 Updating guidelines for management of perioperative anaemia in light of the results of translational research.
4 There will be a potential for major cost-saving by applying this approach in treating perioperative anaemia.

MedicalResearch.com: Is there anything else you would like to add
Response: Undoubtedly, guidelines should integrate the latest research and consider logistical factors when making recommendations. Other factors specific to the context can influence the algorithm for diagnosis and management of perioperative anaemia including private/public, rural/urban, regional/referral centres, primary/ tertiary health system, elective/non-elective surgery and finally country/continent of origin. The success of a guideline should be measured not only by its recommendations but also
by its ability to be applied to different contexts.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Intravenous ferric carboxymaltose versus standard care in the management of postoperative anaemia: a prospective, open-label, randomised controlled trial
Khalafallah, Alhossain A et al.
The Lancet Haematology , Volume 0 , Issue 0
Prof Alhossain A Khalafallah, FRACP , Carl Yan, MB, Raghad Al-Badri, MBBS, Ella Robinson, MBBS, Brooke E Kirkby, MBBS, Emily Ingram, MBBS, Zara Gray, MBBS, Vinod Khelgi, MBBS, Iain K Robertson, MMedSci, Brian P Kirkby, FRACS
Published Online: 04 August 2016

DOI: http://dx.doi.org/10.1016/S2352-3026(16)30078-3

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Last Updated on August 6, 2016 by Marie Benz MD FAAD

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