Patterns and determinants of functional and absolute iron deficiency in patients undergoing cardiac rehabilitation following heart surgery
Autor: | Roberto Tramarin, Carlo De Vincentiis, Serenella Castelvecchio, Valeria Pistuddi, Marco Pavesi, Luigi Maresca, Lorenzo Menicanti, Marco Ranucci |
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Rok vydání: | 2017 |
Předmět: |
medicine.medical_specialty
Time Factors Valve surgery Databases Factual Epidemiology Anemia medicine.medical_treatment Iron 030204 cardiovascular system & hematology Risk Assessment 03 medical and health sciences 0302 clinical medicine Aortic valve replacement Risk Factors Internal medicine medicine Odds Ratio Humans In patient 030212 general & internal medicine Coronary Artery Bypass Retrospective Studies Heart Valve Prosthesis Implantation Rehabilitation Cardiac Rehabilitation Cardiopulmonary Bypass Chi-Square Distribution Anemia Iron-Deficiency business.industry Transferrin Iron deficiency Length of Stay medicine.disease Surgery Cardiac surgery Logistic Models Treatment Outcome Cardiac Surgery procedures Ferritins Cardiology Cardiology and Cardiovascular Medicine business Biomarkers |
Zdroj: | European journal of preventive cardiology. 24(8) |
ISSN: | 2047-4881 |
Popis: | 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 saturation20% and serum ferritin ≥100 µg/l. Absolute iron deficiency was defined in the presence of serum ferritin values100 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. |
Databáze: | OpenAIRE |
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