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Short-term preoperative intravenous iron replacement: Impact on surgical outcomes in cardiovascular disease

Fatoş Dilan Köseoğlu¹, Ahmet Daylan², Ömer Faruk Rahman², Dağlar Cansu², Enver Oğuzhan Metehan², Şahin Bozok<sup>2

1</sup>Department of Internal Medicine, Division of Hematology, Izmir Bakırçay University, Izmir, Türkiye
²Department of Cardiovascular Surgery, Izmir Bakırçay University, Izmir, Türkiye

Keywords: Anemia, intravenous iron replacement, mortality, open heart surgery

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Objectives: This study aimed to compare surgical outcomes between patients scheduled for cardiovascular surgery diagnosed with anemia according to the World Health Organization criteria who received intravenous iron replacement and those who were not anemic.

Patients and methods: This retrospective study analyzed patients who underwent cardiovascular surgery between February 2021 and January 2024. Patients with preoperative anemia treated with intravenous iron replacement were compared with nonanemic patients. Data on demographics, preoperative conditions, surgical details, and postoperative outcomes were analyzed.

Results: Of the 193 patients (142 males, 51 females; mean age: 62±10 years; range, 27 to 82 years) analyzed, 173 survived, and 20 did not. Surviving patients were younger and had a lower body mass index. Comorbidities such as congestive heart failure and a history of cerebrovascular events were associated with mortality. Laboratory results showed significant differences in hemoglobin levels and iron binding capacity between survivors and nonsurvivors. The study found no significant differences in surgical procedures or reoperation rates between the groups. However, nonsurvivors had more postoperative complications. Multivariate analysis identified cardiopulmonary bypass time and new-onset acute renal failure as independent risk factors for 30-day mortality. Anemic patients treated with intravenous iron replacement had comparable perioperative outcomes to nonanemic patients, including similar lengths of intensive care unit and hospital stays and mortality rates.

Conclusion: Treatment of preoperative anemia with intravenous iron replacement in patients undergoing cardiovascular surgery resulted in outcomes comparable to those of nonanemic patients. This suggests that short-term intravenous iron replacement may be an effective strategy to improve surgical readiness and outcomes in anemic patients.

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