Key result
Intravenous iron did not significantly reduce the risk of death or blood transfusion at 30 days compared with placebo in patients with absolute iron deficiency (RR 0.76) or functional iron deficiency (RR 1.0), with no significant interaction by baseline ferritin (p=0.33).
Why the study?
In the PREVENTT trial, intravenous iron did not reduce blood transfusion, complications, or hospital stay, prompting this secondary analysis to explore interactions between pre-operative markers of iron deficiency and intervention status on trial outcomes.
Does intravenous iron reduce blood transfusion or death in patients with iron deficiency anaemia undergoing major abdominal surgery?
Population
452 patients undergoing major abdominal surgery in the PREVENTT trial
Comparison
Intravenous iron vs placebo across baseline iron deficiency subgroups
Design
Secondary analysis of a randomized placebo-controlled trial
Follow-up
30 days postoperatively
Authors
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IV iron does not reduce transfusions or complications in major abdominal surgery; leaves open biomarker-guided strategies.
RCT (n=452)
Double-blind
1:1
Yes
Does intravenous iron reduce blood transfusion or death in patients with iron deficiency anaemia undergoing major abdominal surgery?
Relative Risk: 0.76 (95% CI 0.4–1.42)
Absolute Event Rate: 18.7% vs 24.6%
p-value: p=0.39
Intravenous iron does not reduce the need for blood transfusion or death at 30 days postoperatively in patients with iron deficiency anaemia undergoing major abdominal surgery, regardless of baseline iron status.
Richards et al. (2022) conducted an RCT in Pre-operative anaemia in patients undergoing major abdominal surgery (n=452). Intravenous iron (ferric carboxymaltose) vs. Placebo (saline) was evaluated on Death or any blood transfusion within 30 days (absolute iron deficiency subgroup) (RR 0.76, 95% CI 0.40-1.42, p=0.39). Intravenous iron did not significantly reduce the risk of death or blood transfusion at 30 days compared with placebo in patients with absolute iron deficiency (RR 0.76) or functional iron deficiency (RR 1.0), with no significant interaction by baseline ferritin (p=0.33).
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