Intravenous Iron Preparations for Patients Undergoing Elective Surgery: A 2022 Update

Key Message

For adults who are iron deficient before elective surgery, patients who received IV iron supplementation may have greater increases in hemoglobin and ferritin concentrations, similar or lower lengths of stay in hospital, and similar quality of life measures, functional outcomes, and rates of adverse events, compared to patients who did not receive IV supplementation. The findings were mixed for the rate of blood transfusions.

For adults who are iron deficient before elective surgery, patients who received IV iron supplementation may experience similar changes in hemoglobin levels, quality of life scores, or number of adverse events when compared to patients who received oral iron supplementation. The findings were mixed regarding the risk of blood transfusions.

No studies were found on the cost-effectiveness of IV iron preparation therapy for patients who are iron deficient undergoing elective surgery that met the criteria for this review.

One guideline recommends the use of IV iron supplementation for patients with iron deficient anemia when surgery is less than 8 weeks away, patients are unable to tolerate or absorb oral iron supplementation, or for patient with suboptimal hemoglobin levels.