The Effect of Perioperative Intravenous Iron on Hemoglobin in Surgical Patients: A Meta-Analysis

source extracted confidence: high 2026-04-09
#administration-intravenous #administration-oral #blood-loss-surgical #blood-transfusion #ferric-compounds

The Effect of Perioperative Intravenous Iron on Hemoglobin in Surgical Patients: A Meta-Analysis

Koo et al., 2020 | J Surg Res | Meta Analysis

Citation

Koo Chang-Hoon, Shin Hyun-Jung, ... Ryu Jung-Hee. The Effect of Perioperative Intravenous Iron on Hemoglobin in Surgical Patients: A Meta-Analysis. J Surg Res. 2020-Feb;246:42-51. doi:10.1016/j.jss.2019.08.023

Abstract

BACKGROUND: Patient blood management aims to maintain hemoglobin level, minimize blood loss, and avoid unnecessary blood transfusion. Ferric carboxymaltose, an intravenous iron agent, was included as a part of surgical patient blood management strategy. However, it is still controversial that ferric carboxymaltose can reduce transfusion requirements. The purpose of this systematic review and meta-analysis is to evaluate the benefits of perioperative ferric carboxymaltose on the postoperative hematological parameters and transfusion requirements. METHODS: Randomized controlled trials evaluating the effects of ferric carboxymaltose were searched through databases: MEDLINE, EMBASE, CENTRAL, CINAHL, Scopus, Web of Science, and KoreaMed. Meta-analysis was performed using random effect models. RESULTS: A total of 8 studies (n = 471) were included in the final analysis. Postoperative hemoglobin was higher in the ferric carboxymaltose group than in the control group (mean difference [MD], 0.58 g/dL; 95% confidence interval [CI], 0.36 to 0.80; P < 0.00001). Postoperative serum ferritin and transferrin saturation were also higher in the ferric carboxymaltose group (MD, 373.85 μg/L; 95% CI, 298.13 to 449.56; P < 0.00001; MD, 10.35%; 95% CI, 4.59 to 16.10; P < 0.00001, respectively). However, there were no significant differences in the number of transfused patients, length of hospital stay, and adverse events between groups. Subgroup analysis revealed that adverse events were lower in the ferric carboxymaltose group than the oral iron group. CONCLUSIONS: This study supports that ferric carboxymaltose may increase the postoperative hemoglobin level in surgical patients. However, transfusion requirements could not be reduced by ferric carboxymaltose. Optimal dose and time should be further analyzed.

Key Findings

A total of 8 studies (n = 471) were included in the final analysis. Postoperative hemoglobin was higher in the ferric carboxymaltose group than in the control group (mean difference [MD], 0.58 g/dL; 95% confidence interval [CI], 0.36 to 0.80; P < 0.00001). Postoperative serum ferritin and transferrin saturation were also higher in the ferric carboxymaltose group (MD, 373.85 μg/L; 95% CI, 298.13 to 449.56; P < 0.00001; MD, 10.35%; 95% CI, 4.59 to 16.10; P < 0.00001, respectively). However, there

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 471
Age Range See abstract
Condition See abstract

MeSH Terms

  • Administration, Intravenous
  • Administration, Oral
  • Blood Loss, Surgical
  • Blood Transfusion
  • Ferric Compounds
  • Hemoglobins
  • Humans
  • Maltose
  • Perioperative Care
  • Postoperative Hemorrhage
  • Postoperative Period
  • Randomized Controlled Trials as Topic
  • Treatment Outcome

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: iron

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09