Département d'Anesthésie-Réanimation Chirurgicale, AP-HP, CHU Bichat-Claude Bernard, Université denis.diderot Paris 7, F-75018 Paris, France.
Eur J Anaesthesiol. 2011 Nov;28(11):796-801. doi: 10.1097/EJA.0b013e32834ad97b.
Iron deficiency is the commonest cause of anaemia. It is apparent preoperatively in cardiac surgery patients and may influence transfusion requirements. In addition, iron deficiency per se is associated with fatigue.
To determine the prevalence of preoperative iron deficiency and its association with perioperative anaemia, blood transfusions and fatigue in cardiac surgery patients.
Academic hospital in Paris, France.
One hundred consecutive patients without known iron disorder and scheduled for cardiac surgery were prospectively included in this observational study.
No intervention was performed.
A biological iron profile (transferrin saturation, ferritin, soluble transferrin receptor and C-reactive protein) was assessed on the day of surgery. Diagnosis of iron deficiency was defined using a previously published algorithm. Patient fatigue was assessed before surgery and 1 week afterwards (day 7) using the Multidimensional Fatigue Inventory (MFI-20) score that quotes five distinctive dimensions of fatigue.
Thirty-seven out of 100 patients were diagnosed with iron deficiency. These patients were younger [median (first-third quartile) 63 (43-70) vs. 70 (59-77) years (P = 0.004)], and more often female (51 vs. 21%, P = 0.003), than no iron deficiency patients. Preoperative iron deficiency was associated with lower preoperative haemoglobin levels (P = 0.006) and higher perioperative transfusion rates during the first week (62 vs. 35%, P = 0.019). Patients with iron deficiency but without anaemia (n = 25) received more packed red blood cells units than those without iron deficiency or anaemia (n = 50) [2 (0-2) vs. 0 (0-0) units, P < 0.05). Preoperative iron deficiency was associated with higher score of physical fatigue on day 7 (P = 0.01).
Preoperative iron deficiency is frequent among cardiac surgery patients and is associated with anaemia, higher transfusion requirements and postoperative fatigue.
缺铁是贫血最常见的原因。在心脏手术患者中，缺铁在术前就很明显，可能会影响输血需求。此外，缺铁本身与疲劳有关。
确定术前缺铁的发生率及其与心脏手术患者围手术期贫血、输血和疲劳的关系。
法国巴黎的一家学术医院。
连续 100 例无已知铁代谢紊乱且拟行心脏手术的患者前瞻性纳入本观察性研究。
未进行任何干预。
在手术当天评估生物铁谱（转铁蛋白饱和度、铁蛋白、可溶性转铁蛋白受体和 C 反应蛋白）。根据先前发表的算法诊断缺铁。在术前和术后 1 周（第 7 天）使用多维疲劳量表（MFI-20）评估患者的疲劳，该量表引用了疲劳的五个不同维度。
100 例患者中有 37 例被诊断为缺铁。这些患者更年轻[中位数（第 1 四分位数-第 3 四分位数）63（43-70）岁比 70（59-77）岁，P=0.004]，女性更多（51%比 21%，P=0.003）。术前缺铁与术前血红蛋白水平较低（P=0.006）和术后第 1 周更高的输血率相关（62%比 35%，P=0.019）。有缺铁但无贫血的患者（n=25）比无缺铁或贫血的患者（n=50）接受更多的红细胞单位[2（0-2）比 0（0-0）单位，P<0.05]。术前缺铁与术后第 7 天的身体疲劳评分较高相关（P=0.01）。
术前缺铁在心脏手术患者中很常见，与贫血、更高的输血需求和术后疲劳有关。
