| Meyer et al. (2022)16 SR and MA (Based on 3 included studies) |
Hemoglobin concentration at time of admission
Combined total concentration for patients who received pre-operative IV iron = 258 g/dl
Combined total concentration for no treatment = 256 g/dl
Mean difference (95% CI) = 0.81 (0.30 to 1.33); P = 0.002; I2 = 60%
|
| Tang et al. (2022)17 SR and MA (Based on 3 included studies) |
Effect of iron therapy on hemoglobin concentrations (units not specified)
Combined total concentration for patients who received IV iron therapy = 123
Combined total concentration for control group = 213
Mean difference (95% CI) = 0.29 (0.02 to 0.56); P = 0.04; I2 = 77%
|
| Chaudhry et al. (2021)18 SR (1 RCT, Na et al. 2011) |
Mean pre-operative hemoglobin levels
IV iron therapy group = 12 g/dl
Control group = 12 g/dl
Mean postoperative hemoglobin levels
POD 1, 2, 3, 2 week and 6-week follow-up significantly favours the intervention; POD 5 was not significant
|
| Chaudhry et al. (2021)18 SR (1 RCT, Bisbe et al. 2014) |
Mean pre-operative hemoglobin levels
IV iron group = 14 g/dl
Oral iron group = 14 g/dl
Mean follow-up hemoglobin levels (SD)
IV iron group = 12 g/dl (1.2)
Oral iron group = 11 g/dl (1.1)
Pre- to postoperative change in hemoglobin
POD 30 change was not significant for all patients; Subset analysis of pre-operative low iron or severe postoperative anemia was significant favouring IV iron therapy (1.9 g/dl vs 1.2 g/dl pre-operative low iron subset; 2.4 g/dl vs 1.1 g/dl severe postoperative anemia subset)
Mean postoperative hemoglobin levels
POD 1, 4 and 30 was not significant for all patients; Subset analysis of pre-operative low iron or severe postoperative anemia was significant favouring IV iron therapy
Rate of anemia at final follow-up
POD 30 significantly favours IV iron therapy group (58% IV iron vs 76% oral iron)
|
| Chaudhry et al. (2021)18 SR (1 RCT, Park et al. 2019) |
Mean pre-operative hemoglobin levels
IV iron group = 12 g/dl
Placebo group = 13 g/dl
Mean follow-up hemoglobin levels (SD)
IV iron group = 13 g/dl (1.3)
Placebo group = 13 g/dl (1.1)
Pre- to postoperative change in hemoglobin
POD 1 and 5 change was not significant for all patients; POD 30 change was significant favouring IV iron group (0.3 g/dl vs -0.8 g/dl)
Mean postoperative hemoglobin levels
POD 1, 5 and 30 was not significant between groups
|
| Chaudhry et al. (2021)18 SR (1 RCT, Yoo et al. 2019) |
Mean pre-operative hemoglobin levels
IV iron group = 14 g/dl
Control group = 13 g/dl
Mean follow-up hemoglobin levels (SD)
IV iron group = 13 g/dl (0.9)
Control group = 12 g/dl (1.0)
Mean postoperative hemoglobin levels
POD 1 and 7 was not significant for all patients; POD 30 was significant favouring the IV iron group
Rate of anemia at final follow-up
POD 30 significantly favours IV iron therapy group (34% IV iron vs 62% control group)
|
| Elhenawy et al. (2021)19 SR and MA |
Change in hemoglobin levels at post-treatment (random effects model based on 7 included studies)
Combined total hemoglobin level for patients who received IV iron therapy = 298 g/L
Combined total hemoglobin level for placebo or standard of care group = 282 g/L
Mean difference (95% CI) = 7.15 (2.26 to 12.04); P = 0.004; I2 = 79%
Direct comparison between IV iron and oral iron therapy for change in hemoglobin levels at post-treatment (random effects model based on 5 included studies)
Combined total hemoglobin level for patients who received IV iron therapy = 224 g/L
Combined total hemoglobin level for patients who received oral iron therapy = 225 g/L
Mean difference (95% CI) = 7.63 (1.41 to 13.86); P = 0.02; I2 = 87%
Change in hemoglobin levels at > 4 weeks postoperative follow-up (random effects model based on 4 included studies)
Combined total hemoglobin level for patients who received IV iron therapy = 227 g/L
Combined total hemoglobin level for placebo or standard of care group = 282 g/L
Mean difference (95% CI) = 6.46 (3.10 to 9.81); P = 0.0002; I2 = 33%
|
| Jones et al. (2021)20 SR (1 RCT, Khalafallah et al. 2016) |
Mean change in hemoglobin from postoperative day 1 to postoperative week 12 (SD)a
IV iron group = 3.2 g/dl (0.16)
Standard of care group = 2.81 g/dl (0.18)
|
| Jones et al. (2021)20 SR (1 RCT, Kim et al. 2017) |
Increase in hemoglobin level from baseline to postoperative week 12a
IV iron group = 3.3 g/dl
Placebo = 1.6 g/dl
|
| Jones et al. (2021)20 SR (1 RCT, Padmanabhan et al. 2019) |
Change in mean hemoglobin level between enrollment and surgical admission (SD)a
IV iron group = 1.3 g/dl (0.9)
Oral iron group = 4.4 g/dl (0.9)
|
| Moon et al. (2021)21 SR (1 retrospective cohort study, Wilson et al. 2018) |
Mean change in hemoglobin from iron deficiency anemia diagnosis to admission
IV iron group = 1.05 g/dl
Control group = 0.16 g/dl
P < 0.0001
|
| Moon et al. (2021)21 SR (1 retrospective and prospective cohort study, Calleja et al. 2015) |
Mean change in hemoglobin from iron deficiency anemia diagnosis to admission
IV iron group = 1.5 g/dl
Control group = 0.5 g/dl
P < 0.0001
|
| Moon et al. (2021)21 SR (1 prospective cohort study, Kam et al. 2020) |
Mean change in hemoglobin from iron deficiency anemia diagnosis to admission
IV iron group = 1.9 g/dl
Control group = 0.6 g/dl
P < 0.001
|
| Fung et al. (2022)22 RCT |
Mean change in hemoglobin from baseline to before surgery (95% CI)
IV iron group = 7.9 g/L (3.2 to 12.3)
Control group = 1.7 g/L (-1.9 to 5.3)
P = 0.040
|
| Kvaslerud et al. (2022)23 RCT |
Mean hemoglobin from baseline to follow-up (SD)
Mean IV iron group hemoglobin at baseline = 13.3 g/L (1.2); Mean IV iron group hemoglobin at follow-up = 13.7 g/L (1.4)
Mean placebo group hemoglobin at baseline = 13.3 g/L (1.3); Mean placebo group hemoglobin at follow-up = 13.1 g/L (1.5)
Mean difference (95% CI) = 0.6 g/L (0.1 to 1.0); P = 0.015
|
| Shokri et al. (2022)24 RCT |
Mean hemoglobin levels on admission between IV iron group and placebo group (SD)
IV iron group = 9.53 g/dl (0.84)
Placebo group = 9.77 g/dl (0.74)
P = 0.103
Mean pre-operative hemoglobin levels between IV iron group and placebo group (SD)
IV iron group = 12.76 g/dl (0.88)
Placebo group = 10.03 g/dl (0.83)
P < 0.001
Mean postoperative hemoglobin levels between IV iron group and placebo group (SD)
IV iron group = 9.1 g/dl (0.63)
Placebo group = 7.55 g/dl (0.6)
P < 0.001
Mean hemoglobin levels 1 week after discharge between IV iron group and placebo group (SD)
IV iron group = 10.35 g/dl (0.89)
Placebo group = 10.18 g/dl (0.85)
P = 0.397
Mean hemoglobin levels 4 weeks after discharge between IV iron group and placebo group (SD)
IV iron group = 12.44 g/dl (0.71)
Placebo group = 11.26 g/dl (1.13)
P < 0.001
Incidence of anemia 4 weeks after discharge between IV iron group (N = 40) and placebo group (N = 40), n (%)
IV iron group = 13 (32%)
Placebo group = 32 (80%)
P < 0.001
|
| Thin et al. (2021)25 RCT |
Mean rise in hemoglobin level between IV iron group and oral iron group (SD)
IV iron group = 0.2 g/dl (1.6)
Oral iron group = 0.8 g/dl (0.7)
P = 0.3
|
| Ploug et al. (2022)26 Retrospective cohort study |
Change between baseline and pre-operative hemoglobin levels for IV iron group and control group (range)
IV iron group = 0.64 g/dl (0.32 to 1.61)
Control group = 0.48 g/dl (0.81 to 2.09)
P = 0.94
|
| Evans et al. (2021)28 Retrospective cohort study |
Comparison of mean hemoglobin levels at pre-assessment phase (SD)
IV treatment responsive group = 120 g/l-1 (7)
IV treatment unresponsive group = 114 g/l-1 (9)
Untreated anemic group = 121 g/l-1 (7)
Non-anemic group = 146 g/l-1 (10)
P < 0.001
Comparison of mean hemoglobin levels at pre-surgery phase (SD)
IV treatment responsive group = 137 g/l-1 (8)
IV treatment unresponsive group = 120 g/l-1 (7)
Untreated anemic group = 119 g/l-1 (10)
Non-anemic group = 143 g/l-1 (11)
P < 0.001
Comparison of mean hemoglobin levels at post-surgery phase (SD)
IV treatment responsive group = 111 g/l-1 (17)
IV treatment unresponsive group = 104 g/l-1 (11)
Untreated anemic group = 106 g/l-1 (15)
Non-anemic group = 115 g/l-1 (16)
P < 0.001
Change in mean hemoglobin levels from pre-assessment to pre-operative phase (95% CI)
IV treatment responsive group = 17 g/l-1 (13 to 21)
IV treatment unresponsive group = 6 g/l-1 (3 to 8)
Untreated anemic group = -2 g/l-1 (-4 to 0)
Non-anemic group = -2 g/l-1 (-3 to -1)
P < 0.001
Change in mean hemoglobin levels from pre-operative to postoperative phase (95% CI)
IV treatment responsive group = -26 g/l-1 (-31 to -19)
IV treatment unresponsive group = -16 g/l-1 (-20 to -12)
Untreated anemic group = -13 g/l-1 (-16 to -9)
Non-anemic group = -29 g/l-1 (-31 to -27)
P = NR
|
| Peel et al. (2021)29 Retrospective cohort study |
Change in hemoglobin level between referral and pre-operative level for each relevant group (95% CI)
IV iron 1 to 300 mg group = 2.49 g/L (-0.68 to 5.66); P = 0.1238
IV iron 301 to 600 mg group = 1.48 g/L (-1.73 to 4.69); P = 0.3646
IV iron > 600 mg group = 9.80 g/L (6.17 to 13.42); P < 0.0001
Oral iron group = 1.62 g/L (-0.85 to 4.08); P = 0.1974
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