Baltimore, MD (July 22, 2024) — Researchers at Johns Hopkins Medicine have discovered that patients with preoperative anemia experience improved outcomes when treated with iron infusions prior to surgery, as opposed to the conventional method of red blood cell transfusions. These significant findings were published on July 22 in the journal Anesthesia & Analgesia.
The study indicates that iron infusions, which enhance the production of the patient’s own red blood cells, may offer a superior alternative to transfusions from external donors.
“Anemia is incredibly common, especially in surgical patients, and until recently the default treatment has been blood transfusions prior to the procedure,” said Dr. Steven Frank, professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine. “However, our retrospective study showed a benefit of iron infusions over preoperative blood transfusions in decreasing morbidity and mortality, increasing hemoglobin and decreasing the need for blood transfusions.”
Iron is essential for producing hemoglobin, the protein in red blood cells responsible for carrying oxygen throughout the body. Anemic patients, who lack sufficient healthy red blood cells, are at a heightened risk during surgery due to inevitable blood loss.
Although blood transfusions are effective, they carry risks such as blood clots, infections, allergic reactions, and pulmonary complications. Additionally, finding suitable donors can be challenging for patients with specific antibodies or conditions like sickle cell disease. This has driven the search for alternative treatment strategies.
The research team utilized data from the TriNetX Research Network, analyzing records from 154,358 patients with iron-deficient anemia who underwent surgery between 2003 and 2023. Patients were categorized into those who received preoperative iron infusions and those who had blood transfusions. The results showed a 37% reduction in mortality and a 24% reduction in morbidity among patients treated with iron infusions compared to those who received transfusions.
The study’s authors hope these findings will encourage the broader adoption of preoperative iron infusions. Future research may explore the effectiveness of oral iron supplements compared to infusions.