Background/Objectives:Iron deficiency anaemia (IDA) is a common complication in patients with colorectal cancer presenting for surgery. Perioperative IDA is associated with increased post-operative mortality and morbidity. The impact on clinical outcomes for the active management of anaemia before surgery, with treatments such as intravenous (IV) iron, is uncertain.Methods:We performed a single-centre nested cohort study, analysing prospectively collected data from patients with colorectal cancer who were treated with IV iron prior to elective major abdominal surgery. Cox proportional hazard models were used to quantify the effect of anaemia treatment on length of stay. Other outcomes, including transfusion rates, were estimated using logistic regression analyses. Models were adjusted for age, sex, comorbidities and surgical details.Results:The length of stay was longer for patients with untreated anaemia compared to patients without anaemia (adjusted hazard ratio, HR 0.66 [95% confidence interval, CI 0.45, 0.95]). For patients with anaemia, the length of stay was shorter in those treated when compared to those not treated (adjusted HR 0.59 [95% CI 0.45, 0.78]). Patients with untreated anaemia had higher transfusion rates than patients with treated anaemia (adjusted odds ratio, OR 0.35 [95% CI 0.18, 0.66]) and non-anaemic patients (adjusted odds ratio, OR 0.20 [95% CI 0.07, 0.55]).Conclusions:This study suggests that treating iron deficiency anaemia with IV iron pre-operatively reduces length of stay and transfusion rates in colorectal cancer patients.
背景/目的：缺铁性贫血是结直肠癌患者术前常见的并发症。围手术期缺铁性贫血与术后死亡率和并发症发生率增加相关。术前通过静脉补铁等方式积极治疗贫血对临床结局的影响尚不明确。 方法：我们进行了一项单中心巢式队列研究，前瞻性分析了择期腹部大手术前接受静脉铁剂治疗的结直肠癌患者数据。采用Cox比例风险模型量化贫血治疗对住院时间的影响。其他结局指标（包括输血率）则通过逻辑回归分析进行评估。所有模型均根据年龄、性别、合并症及手术细节进行了校正。 结果：与无贫血患者相比，未治疗贫血患者的住院时间更长（校正风险比HR 0.66 [95%置信区间CI 0.45, 0.95]）。在贫血患者中，接受治疗者较未治疗者住院时间显著缩短（校正HR 0.59 [95% CI 0.45, 0.78]）。未治疗贫血患者的输血率高于治疗组（校正比值比OR 0.35 [95% CI 0.18, 0.66]）及非贫血患者（校正OR 0.20 [95% CI 0.07, 0.55]）。 结论：本研究表明，术前静脉铁剂治疗缺铁性贫血可缩短结直肠癌患者的住院时间并降低输血率。
Intravenous Iron for Perioperative Anaemia in Colorectal Cancer Surgery: A Nested Cohort Analysis
肿瘤(癌症)患者之家