Key result
Non-anaemic iron deficiency linked to ~2.3 mL/kg/min lower peak VO2 before hepatopancreatobiliary surgery.
Why the study?
The impact of non-anaemic iron deficiency on exercise capacity and postoperative outcomes in patients undergoing major surgery is not addressed in current consensus guidelines.
Does non-anaemic iron deficiency reduce VO2 peak in patients undergoing liver or pancreatic resection surgery?
Observational
No
Does non-anaemic iron deficiency reduce VO2 peak in patients undergoing liver or pancreatic resection surgery?
Absolute Event Rate: 17.8% vs 20.1%
p-value: p=0.0137
Non-anaemic iron deficiency is associated with significantly reduced cardiopulmonary fitness (VO2 peak) in patients undergoing major non-cardiac surgery.
anaemia, non-anaemic iron deficient; and non-anaemic iron replete.A one-sided p value was calculated for the difference in the VO 2 peak between the non-anaemic iron deficient and non-anaemic iron replete groups. Results:The baseline characteristics of the non-anaemic iron deficient and non-anaemic iron replete groups were well matched for age, sex, weight and haemoglobin concentration.Median VO2 peak in the nonanaemic iron deficient group was 17.8 (16.0-20.9[11.8-33.2])ml.kg-1.min-1,which was significantly lower than in the non-anaemic iron replete group, 20.1 (16.9-22.7 [11.2-37.5])ml.kg-1.min-1(p = 0.0137). Conclusion:This retrospective observational study demonstrates an association between non-anaemic iron deficiency and reduced exercise capacity in patients undergoing liver or pancreatic resection surgery.This finding aligns with evidence from non-surgical populations.If Iron supplementation is shown to improve cardiopulmonary fitness in nonanaemic iron deficient surgical patients as it has done in medical patients, it could provide a valuable addition to prehabilitation strategies for patients with low fitness levels.This approach would support investigating for iron deficiency in non-anaemic patients anticipating major surgery.Currently, this is not recommended in consensus guidelines.
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Avlessi et al. (2026) conducted an observational in Patients undergoing liver or pancreatic resection surgery. Non-anaemic iron deficiency vs. Non-anaemic iron replete was evaluated on VO2 peak (p=0.0137). Non-anaemic iron deficiency was associated with significantly lower median VO2 peak than iron replete status (17.8 vs 20.1 ml.kg-1.min-1; p=0.0137) in liver or pancreatic resection surgery patients.
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