Improved patient blood management and cost saving in hip replacement surgery through the implementation of pre-operative Sucrosomial® iron supplementation: a quality improvement assessment study.

Abstract

To compare post-operative recovery of prosthetic hip surgery patients with or without the implementation of iron supplementation with a new highly absorbable oral iron formulation. Observational retrospective quality improvement assessment conducted on patients who had undergone elective prosthetic hip surgery (first implant) with ferritin < 100mcg/dl and Hb values between 13 and 14g/dl for men and 12g/dl and 13.5g/dl for women, or having ferritin levels > 100mcg/dl but C-reactive protein (CRP) > 3mg/l and transferrin saturation (TSAT) < 20%, which together are suggestive of functional iron deficiency. The analysis compared a group of non-anaemic patients having ferritin levels > 100mcg/l to two groups of patients with iron deficiency, of which only one received iron supplementation. Measurements included haemoglobin levels, length of hospital stay, and number of transfused patients/blood units. Patients with iron deficiency supplemented with Sideral® Forte compared to non-supplemented patients showed a smaller decline in post-operative Hb (9.7 ± 1.24g/dl vs 8.4 ± 0.6g/dl), required shorter hospital stay (4 vs 6.5days) and less blood transfusions (0 in the iron-supplemented group vs 7units in the non-iron-supplemented group), yielding an overall savings of 1763.25 €/patient. Pre-operative sucrosomial iron supplementation at least 4weeks prior to elective surgery in non-anaemic patients limits the drop in post-operative Hb levels, determining higher post-operative haemoglobin, quicker post-surgical recovery, shorter hospitalisation, and decreased surgery-related costs.