Patterns and determinants of functional and absolute iron deficiency in patients undergoing cardiac rehabilitation following heart surgery

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Abstract

© European Society of Cardiology 2017. Background Anaemia and iron deficiency are frequent following major surgery. The present study aims to identify the iron deficiency patterns in cardiac surgery patients at their admission to a cardiac rehabilitation programme, and to determine which perioperative risk factor(s) may be associated with functional and absolute iron deficiency. Design This was a retrospective study on prospectively collected data. Methods The patient population included 339 patients. Functional iron deficiency was defined in the presence of transferrin saturation <20% and serum ferritin ≥100 μg/l. Absolute iron deficiency was defined in the presence of serum ferritin values <100 μg/l. Results Functional iron deficiency was found in 62.9% of patients and absolute iron deficiency in 10% of the patients. At a multivariable analysis, absolute iron deficiency was significantly (p = 0.001) associated with mechanical prosthesis mitral valve replacement (odds ratio 5.4, 95% confidence interval 1.9-15) and tissue valve aortic valve replacement (odds ratio 4.5, 95% confidence interval 1.9-11). In mitral valve surgery, mitral repair carried a significant (p = 0.013) lower risk of absolute iron deficiency (4.4%) than mitral valve replacement with tissue valves (8.3%) or mechanical prostheses (22.5%). Postoperative outcome did not differ between patients with functional iron deficiency and patients without iron deficiency; patients with absolute iron deficiency had a significantly (p = 0.017) longer postoperative hospital stay (median 11 days) than patients without iron deficiency (median nine days) or with functional iron deficiency (median eight days). Conclusions Absolute iron deficiency following cardiac surgery is more frequent in heart valve surgery and is associated with a prolonged hospital stay. Routine screening for iron deficiency at admission in the cardiac rehabilitation unit is suggested.
Original languageEnglish
Pages (from-to)799-807
Number of pages9
JournalEuropean Journal of Preventive Cardiology
Volume24
Issue number8
DOIs
Publication statusPublished - May 1 2017

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Thoracic Surgery
Iron
Mitral Valve
Cardiac Rehabilitation
Ferritins
Prostheses and Implants
Length of Stay
Odds Ratio
Confidence Intervals
Iron-Deficiency Anemias
Heart Valves
Transferrin
Serum
Aortic Valve
Retrospective Studies

Keywords

  • anaemia
  • Cardiac surgery
  • iron deficiency

Cite this

@article{8a8d3349bc1a4db09dc440dbdcc2905f,
title = "Patterns and determinants of functional and absolute iron deficiency in patients undergoing cardiac rehabilitation following heart surgery",
abstract = "{\circledC} European Society of Cardiology 2017. Background Anaemia and iron deficiency are frequent following major surgery. The present study aims to identify the iron deficiency patterns in cardiac surgery patients at their admission to a cardiac rehabilitation programme, and to determine which perioperative risk factor(s) may be associated with functional and absolute iron deficiency. Design This was a retrospective study on prospectively collected data. Methods The patient population included 339 patients. Functional iron deficiency was defined in the presence of transferrin saturation <20{\%} and serum ferritin ≥100 μg/l. Absolute iron deficiency was defined in the presence of serum ferritin values <100 μg/l. Results Functional iron deficiency was found in 62.9{\%} of patients and absolute iron deficiency in 10{\%} of the patients. At a multivariable analysis, absolute iron deficiency was significantly (p = 0.001) associated with mechanical prosthesis mitral valve replacement (odds ratio 5.4, 95{\%} confidence interval 1.9-15) and tissue valve aortic valve replacement (odds ratio 4.5, 95{\%} confidence interval 1.9-11). In mitral valve surgery, mitral repair carried a significant (p = 0.013) lower risk of absolute iron deficiency (4.4{\%}) than mitral valve replacement with tissue valves (8.3{\%}) or mechanical prostheses (22.5{\%}). Postoperative outcome did not differ between patients with functional iron deficiency and patients without iron deficiency; patients with absolute iron deficiency had a significantly (p = 0.017) longer postoperative hospital stay (median 11 days) than patients without iron deficiency (median nine days) or with functional iron deficiency (median eight days). Conclusions Absolute iron deficiency following cardiac surgery is more frequent in heart valve surgery and is associated with a prolonged hospital stay. Routine screening for iron deficiency at admission in the cardiac rehabilitation unit is suggested.",
keywords = "anaemia, Cardiac surgery, iron deficiency",
author = "Roberto Tramarin and Valeria Pistuddi and Luigi Maresca and Marco Pavesi and Serenella Castelvecchio and Lorenzo Menicanti and {De Vincentiis}, Carlo and Marco Ranucci",
year = "2017",
month = "5",
day = "1",
doi = "10.1177/2047487317689975",
language = "English",
volume = "24",
pages = "799--807",
journal = "European Journal of Preventive Cardiology",
issn = "2047-4873",
publisher = "SAGE Publications Ltd",
number = "8",

}

TY - JOUR

T1 - Patterns and determinants of functional and absolute iron deficiency in patients undergoing cardiac rehabilitation following heart surgery

AU - Tramarin, Roberto

AU - Pistuddi, Valeria

AU - Maresca, Luigi

AU - Pavesi, Marco

AU - Castelvecchio, Serenella

AU - Menicanti, Lorenzo

AU - De Vincentiis, Carlo

AU - Ranucci, Marco

PY - 2017/5/1

Y1 - 2017/5/1

N2 - © European Society of Cardiology 2017. Background Anaemia and iron deficiency are frequent following major surgery. The present study aims to identify the iron deficiency patterns in cardiac surgery patients at their admission to a cardiac rehabilitation programme, and to determine which perioperative risk factor(s) may be associated with functional and absolute iron deficiency. Design This was a retrospective study on prospectively collected data. Methods The patient population included 339 patients. Functional iron deficiency was defined in the presence of transferrin saturation <20% and serum ferritin ≥100 μg/l. Absolute iron deficiency was defined in the presence of serum ferritin values <100 μg/l. Results Functional iron deficiency was found in 62.9% of patients and absolute iron deficiency in 10% of the patients. At a multivariable analysis, absolute iron deficiency was significantly (p = 0.001) associated with mechanical prosthesis mitral valve replacement (odds ratio 5.4, 95% confidence interval 1.9-15) and tissue valve aortic valve replacement (odds ratio 4.5, 95% confidence interval 1.9-11). In mitral valve surgery, mitral repair carried a significant (p = 0.013) lower risk of absolute iron deficiency (4.4%) than mitral valve replacement with tissue valves (8.3%) or mechanical prostheses (22.5%). Postoperative outcome did not differ between patients with functional iron deficiency and patients without iron deficiency; patients with absolute iron deficiency had a significantly (p = 0.017) longer postoperative hospital stay (median 11 days) than patients without iron deficiency (median nine days) or with functional iron deficiency (median eight days). Conclusions Absolute iron deficiency following cardiac surgery is more frequent in heart valve surgery and is associated with a prolonged hospital stay. Routine screening for iron deficiency at admission in the cardiac rehabilitation unit is suggested.

AB - © European Society of Cardiology 2017. Background Anaemia and iron deficiency are frequent following major surgery. The present study aims to identify the iron deficiency patterns in cardiac surgery patients at their admission to a cardiac rehabilitation programme, and to determine which perioperative risk factor(s) may be associated with functional and absolute iron deficiency. Design This was a retrospective study on prospectively collected data. Methods The patient population included 339 patients. Functional iron deficiency was defined in the presence of transferrin saturation <20% and serum ferritin ≥100 μg/l. Absolute iron deficiency was defined in the presence of serum ferritin values <100 μg/l. Results Functional iron deficiency was found in 62.9% of patients and absolute iron deficiency in 10% of the patients. At a multivariable analysis, absolute iron deficiency was significantly (p = 0.001) associated with mechanical prosthesis mitral valve replacement (odds ratio 5.4, 95% confidence interval 1.9-15) and tissue valve aortic valve replacement (odds ratio 4.5, 95% confidence interval 1.9-11). In mitral valve surgery, mitral repair carried a significant (p = 0.013) lower risk of absolute iron deficiency (4.4%) than mitral valve replacement with tissue valves (8.3%) or mechanical prostheses (22.5%). Postoperative outcome did not differ between patients with functional iron deficiency and patients without iron deficiency; patients with absolute iron deficiency had a significantly (p = 0.017) longer postoperative hospital stay (median 11 days) than patients without iron deficiency (median nine days) or with functional iron deficiency (median eight days). Conclusions Absolute iron deficiency following cardiac surgery is more frequent in heart valve surgery and is associated with a prolonged hospital stay. Routine screening for iron deficiency at admission in the cardiac rehabilitation unit is suggested.

KW - anaemia

KW - Cardiac surgery

KW - iron deficiency

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U2 - 10.1177/2047487317689975

DO - 10.1177/2047487317689975

M3 - Article

AN - SCOPUS:85019110284

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JO - European Journal of Preventive Cardiology

JF - European Journal of Preventive Cardiology

SN - 2047-4873

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