[Iron in pre-operative stage and transfusion in patients undergoing hysterectomy].

Abstract

Background: The correction of preoperative anemia is part of the patient blood management program, in order to improve the patient's clinical results by reducing the number of transfusions in surgery. Uterine fibroids can cause anemia, so the application of iron before hysterectomy could reduce transfusion.

Objective: To evaluate the impact of iron treatment in the preoperative stage on the need for transfusion in patients with anemia secondary to myomatosis in the trans and postoperative stage of hysterectomy.

Material and methods: Patients with uterine myomatosis who presented with microcytic anemia in the preoperative stage were included; clinical records were reviewed, the clinical characteristics of the population were obtained; The patients were distributed into two study groups according to whether or not they had received iron treatment; the outcome variable was the transfusion of packed erythrocytes in the first 7 days after surgery.

Results: 134 patients were included, with a median fibroid size of 4 cm. 21 (15.6%) patients used iron. Patients who used iron had a relative risk (RR): 0.36 (95%CI: 0.12-1.07). Delta hemoglobin < 1 g/dL, RR: 1.59 (95%CI: 0.94-2.67). Uterine fibroid size > 5cm had a RR of 1.96 (95%CI: 1.25-3.05).

Conclusion: Treatment with iron in the pre-surgical stage showed a tendency to protect transfusions in the trans and post-surgical stage. The main factor related to transfusion was fibroid size > 5 cm.