Effect of preemptive oral iron supplementation on the recovery of anemia in malnutrition patients after total knee arthroplasty
Objective To observe the effect of preemptive oral iron supplementation on the recovery of anemia in malnutrition patients after total knee arthroplasty(TKA).Methods A total of 89 patients with prognostic nutritional index(PNI)who underwent TKA without blood transfusion and received conventional treatment with recombinant human erythropoietin(EPO)and iron saccharate were collected.They were divided into iron supplementation group and control group according to the supplementation of oral iron succinate before hospitalization or not.Patients in the iron supplementation group were hospitalized for 1-28 days from the date of oral iron supplementation.Information on age,gender,preoperative hemoglobin(Hb),and the specific time of postoperative Hb recovery to 85%of preoperative HB were recorded in both groups.Blood loss was calculated.Differences in Hb,red blood cell count(RBC)and hematocrit(HCT)between the two groups before surgery were compared by one-way ANOVA.The multivariate COX regression was applied to analyze the effect of different time of iron administration on the risk of hemoglobin recovery after surgery,thus investigating the correlation between the preemptive iron supplementation and the recovery process of postoperative anemia.Results Preoperative Hb,RBC and HCT were significantly higher in the iron supplementation group than that of the control group(P<0.05).Preemptive oral iron supplementation was significantly correlated with the postoperative recovery process.The risk of the postoperative hemoglobin compliance was significantly higher in the iron supplementation group than that of the control group(P<0.05)Results were stable after adjusting for confounding factors.Sensitivity analysis showed that the duration of preemptive iron supplementation of 14 days or longer in the iron supplementation group had a significantly higher preoperative Hb than that of control group,but a higher risk of the postoperative hemoglobin compliance(P<0.05).Results were stable after adjusting for confounding factors.The longer preemptive oral iron supplementation time was correlated with the higher preoperative HB and the greater risk of postoperative anemia recovery(P<0.05).Conclusion Preemptive iron supplementation for 14 days or longer can significantly increase preoperative Hb and accelerate the recovery process of anemia after TKA.
total knee arthroplastypreemptive iron supplementationrecombinant human erythropoietiniron sucroseprognosis nutrition index
万方数据
维普
