Clin Orthop Surg.  2018 Mar;10(1):20-25. 10.4055/cios.2018.10.1.20.

Postoperative Intravenous Ferric Carboxymaltose Reduces Transfusion Amounts after Orthopedic Hip Surgery

• Kim SK
• Seo WY
• Kim HJ
• Yoo JJ

• KMID: 2405478
• DOI: http://doi.org/10.4055/cios.2018.10.1.20

Abstract

BACKGROUND
This retrospective study was performed to determine whether postoperative intravenous ferric carboxymaltose reduces transfusion amounts without influencing clinical outcomes in patients that have undergone hip surgery.
METHODS
Between May 2014 and April 2016, the authors adopted a new perioperative blood management protocol involving the administration of intravenous ferric carboxymaltose after hip surgeries. One-to-one matching between the 150 patients treated during this period with 150 patients treated before initiation of the new protocol was performed by propensity scoring for age, sex, diagnosis, and type of hip surgery. Hematologic results and clinical outcomes in these two groups were compared.
RESULTS
Average amounts of perioperative blood loss were not different in the two groups. Ninety-two patients (61%) were transfused in the control group and 70 patients (47%) were transfused in the intravenous ferric carboxymaltose group. The average number of transfused blood units was significantly lower in the intravenous ferric carboxymaltose group (1.7 ± 2.7 units vs. 1.0 ± 1.2 units, p = 0.002). At 6 weeks after surgery, the average hemoglobin concentration recovered to baseline in both groups, but the amount of recovered hemoglobin concentration at 6 weeks was significantly greater in the intravenous ferric carboxymaltose group than in the control group. Clinical outcomes including incidences of postsurgical complications were similar between the two groups.
CONCLUSIONS
This study suggests that postoperative intravenous ferric carboxymaltose injection is associated with reduced transfusion amounts and that intravenous ferric carboxymaltose does not influence clinical outcomes after hip surgery.

Keyword

Anemia; Postoperative hemorrhage; Ferric carboxymaltose; Blood transfusion

MeSH Terms

Anemia
Blood Transfusion
Diagnosis
Hip*
Humans
Incidence
Orthopedics*
Postoperative Hemorrhage
Retrospective Studies

Figure

• 

  Fig. 1 Graph showing changes in perioperative hemoglobin concentrations in the control and intravenous ferric carboxymaltose (IV-FCM) groups. Values are presented as mean ± standard deviation. Pre: preoperative, Post: immediately after surgery, 1 wk: 1 week after surgery, 6 wk: 6 weeks after surgery. *p < 0.05.

• 

  Fig. 2 Graph showing differences in hemoglobin concentrations at 6 weeks after surgery compared to those at the preoperative assessment (Pre–6 wk), immediately after surgery (Post–6 wk), and at 1 week after surgery (1 wk–6 wk). The amount of recovered hemoglobin concentration at 6 weeks was significantly greater in the IV-FCM group than in the control group at all intervals. *p < 0.05.

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