• Anesthesia and analgesia · Aug 2023

    Multicenter Study

    Perioperative Iron Deficiency in Patients Scheduled for Major Elective Surgeries: A French Prospective Multicenter Cross-Sectional Study.

    • Xavier Capdevila, Sigismond Lasocki, Alexis Duchalais, Jean-Christophe Rigal, Patrice Mertl, Pierre Ghewy, Frédéric Farizon, Thomas Lanz, Axel Buckert, Samia Belarbia, Jean-Noël Trochu, and Patrice Cacoub.
    • From the Department of Anesthesiology and Intensive Care Medicine, Lapeyronie University Hospital, Montpellier University, School of Medicine, Montpellier, France.
    • Anesth. Analg. 2023 Aug 1; 137 (2): 322331322-331.

    BackgroundThe management of perioperative iron deficiency is a component of the concept of patient blood management. The objective of this study was to update French data on the prevalence of iron deficiency in patients scheduled for major surgery.MethodsThe CARENFER PBM study was a prospective cross-sectional study in 46 centers specialized in orthopedic, cardiac, urologic/abdominal, or gynecological surgery. The primary end point was the prevalence of iron deficiency at the time of surgery (D-1/D0) defined as serum ferritin <100 µg/L and/or transferrin saturation (TSAT) <20%.ResultsA total of 1494 patients (mean age, 65.7 years; women, 49.3%) were included from July 20, 2021 to January 3, 2022. The prevalence of iron deficiency in the 1494 patients at D-1/D0 was 47.0% (95% confidence interval [CI], 44.5-49.5). At 30 days after surgery, the prevalence of iron deficiency was 45.0% (95% CI, 42.0-48.0) in the 1085 patients with available data. The percentage of patients with anemia and/or iron deficiency increased from 53.6% at D-1/D0 to 71.3% at D30 ( P < .0001), mainly due to the increase of patients with both anemia and iron deficiency (from 12.2% at D-1/D0 to 32.4% at D30; P < .0001). However, a treatment of anemia and/or iron deficiency was administered preoperatively to only 7.7% of patients and postoperatively to 21.7% (intravenous iron, 14.2%).ConclusionsIron deficiency was present in half of patients scheduled for major surgery. However, few treatments to correct iron deficiency were implemented preoperatively or postoperatively. There is an urgent need for action to improve these outcomes, including better patient blood management.Copyright © 2023 International Anesthesia Research Society.

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