Article

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
saturation <20% and serum ferritin >/=100 microg/l. Absolute iron deficiency was
defined in the presence of serum ferritin values <100 microg/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.

Langue : ANGLAIS